CONTRACT_ID	ROLE	TITLE	PREFIX	LAST_NAME	FIRST_NAME	MI	PHONE	PHONE_EXT	ALT_PHONE	ALT_PHONE_EXT	FAX	EMAIL	STREET_ADDRESS	STREET_ADDRESS2	CITY	STATE_CODE	ZIP	LAST_UPDATED	CONTRACT_YEAR	CONTRACT_NAME	ORG_TYPE	MARKETING_NAME	CONTRACT_PLAN_TYPE	EMPLOYER	PARENT_ORGANIZATION_NAME	PARENT_ORGANIZATION_ID	PARTD_OFFERED	CONTRACT_STATUS	TOLLFREE_PHONE	TOLLFREE_EXT	ALT_TOLLFREE_PHONE	ALT_TOLLFREE_PHONE_EXT	NEW_PAYMENT_BILL_OPTION	DEMO_TYPE_FLAG	BILL_OPTION_CODE	REGION_RESPONSIBLE
90091	Chief Financial Officer	Director of Finance and General Services	Mr.	Rodriguez	Samuel		1-202-521-2287				1-202-521-2291	SRodriguez@umwafunds.org	2121 K Street,  NW	Suite 350	Washington	DC	20037	07/02/2020	2023	UNITED MINE WORKERS OF AMERICA HLTH & RETIREMENT	HCPP - 1833 Cost	United Mine Workers of America Health & Retirement	HCPP - 1833 Cost		UMWA Health and Retirement Funds	306	No	Active					HCPP		1	Philadelphia
90091	CMS Casework Communication Contact	Senior Program Manager, Quality/Compliance	Ms	Blackburn	Kimberly		1-202-521-2293				1-202-530-4035	KBlackburn@UMWAFunds.org	160 Heartland Drive		Beckley	WV	25802	10/21/2016	2023	UNITED MINE WORKERS OF AMERICA HLTH & RETIREMENT	HCPP - 1833 Cost	United Mine Workers of America Health & Retirement	HCPP - 1833 Cost		UMWA Health and Retirement Funds	306	No	Active					HCPP		1	Philadelphia
90091	Customer Service Operations Contact	Senior Mgr, Claims Admin & Beneficiary Relations	Ms.	Bailey	Kelly		1-304-256-2633				1-304-256-2604	KBailey@umwafunds.org	UMWA Health & Retirement Funds	160 Heartland Drive	Beckley	WV	25802	05/05/2021	2023	UNITED MINE WORKERS OF AMERICA HLTH & RETIREMENT	HCPP - 1833 Cost	United Mine Workers of America Health & Retirement	HCPP - 1833 Cost		UMWA Health and Retirement Funds	306	No	Active					HCPP		1	Philadelphia
90091	Government Relations Contact	Director of Operations and Eligibility Services	Mr.	Crouch	Jeffery		1-202-521-2304				1-202-521-2260	JCrouch@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	12/10/2018	2023	UNITED MINE WORKERS OF AMERICA HLTH & RETIREMENT	HCPP - 1833 Cost	United Mine Workers of America Health & Retirement	HCPP - 1833 Cost		UMWA Health and Retirement Funds	306	No	Active					HCPP		1	Philadelphia
90091	Medicare Compliance Officer	Director of Operations and Eligibility Services	Mr.	Crouch	Jeffery		1-202-521-2304				1-202-521-2260	JCrouch@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	12/10/2018	2023	UNITED MINE WORKERS OF AMERICA HLTH & RETIREMENT	HCPP - 1833 Cost	United Mine Workers of America Health & Retirement	HCPP - 1833 Cost		UMWA Health and Retirement Funds	306	No	Active					HCPP		1	Philadelphia
E3014	Automated TrOOP Balance Transfer Contact	VP of Operations- HOP Administration Unit		Natalie	Jennifer		1-717-391-7141				1-877-411-4921	jnatalie@trustmarkbenefits.com	1280 N. Plum Street		Lancaster	PA	17601	01/02/2020	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Best Available Evidence Contact	HOP Eligibility Supervisor		Dixon	Ivy		1-717-391-7158				1-877-411-4921	PSERShopeligiblityteam@trustmarkbenefits.com	1280 N. Plum St		Lancaster	PA	17603	01/02/2020	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Chief Financial Officer	Chief Financial Officer	Mr.	Carl	Brian		1-717-720-4905					bcarl@state.pa.us	5 North Fifth St	PO Box 125	Harrisburg	PA	17108-0125	09/05/2008	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	CMS Casework Communication Contact	Senior Health Plan Services Consultant		Winters	Carmen		1-503-314-3388				1-847-378-2989	cwinters@bluepeak.com	2850 Golf Road		Rolling Meadows	IL	60008	08/30/2022	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Coordination of Benefits Contact	Business Analyst		Zeiset	Sheril		1-717-391-7108					szeiset@trustmarkbenefits.com	1280 N Plum Street		Lancaster	PA	17601	12/10/2019	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Customer Service Operations Contact	VP of Operations- HOP Administration Unit		Natalie	Jennifer		1-717-391-7141				1-877-411-4921	jnatalie@trustmarkbenefits.com	1280 N. Plum Street		Lancaster	PA	17601	01/02/2020	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Government Relations Contact	Director, Health Insurance Office	Mr.	Camacci Jr	Peter	P	1-717-720-4859				1-717-772-8760	pcamacci@pa.gov	5 N 5th Street		Harrisburg	PA	17101-1905	01/02/2020	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Hospice Contact	Senior Health Plan Services Consultant		Miller	Greg		1-717-269-7202					gmiller@bluepeak.com	2850 Golf Road		Rolling Meadows	IL	60008	08/30/2022	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Medicare Compliance Officer	Assistant Audit Executive, Benefits & Fin Rptg	Mrs.	Lanius	Stephanie		1-717-720-4640				1-717-783-1741	slanius@pa.gov	5 North Fifth St		Harrisburg	PA	17101-1905	03/10/2021	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Part D Exceptions Contact	Senior Health Plan Services Consultant		Miller	Greg							gmiller@bluepeak.com	2850 Golf Road		Rolling Meadows	IL	60008	08/30/2022	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active	1-717-269-7202				Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Pharmacy Network Management Contact	Director, Pharmacy Networks		Luby	Dwayne		1-949-252-6813				1-949-474-4268	dwayne.luby@optum.com	PO Box 9742		Minneapolis	MN	55440	03/12/2018	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Pharmacy Technical Help Desk Contact	Pharmacy Technical Help		Technical Help	Pharmacy						1-949-474-4268	michael.erbe@optum.com	3515 Harbor Blvd		Costa Mesa	CA	92626	03/12/2018	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active	1-800-797-9791				Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Plan to Plan Reconciliation Contact	VP of Operations- HOP Administration Unit		Natalie	Jennifer		1-717-391-7141				1-877-411-4921	jnatalie@trustmarkbenefits.com	1280 N. Plum Street		Lancaster	PA	17601	01/02/2020	2023	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP		Commonwealth of PA Pub Schools Retirement System	61	Yes	Active					Employer/Union Only Direct Contract PDP		5	Philadelphia
H0022	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/24/2021	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	05/02/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	05/04/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/24/2021	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/24/2021	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0022	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Demo	Buckeye Health Plan - MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0028	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	05/26/2021	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	05/26/2021	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	05/19/2021	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	06/17/2022	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	06/21/2022	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	06/21/2022	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/28/2022	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	05/26/2021	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H0028	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	06/21/2022	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	10/29/2019	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H0028	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	05/26/2021	2023	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0029	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/10/2021	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	09/21/2022	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	09/21/2022	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/10/2021	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0029	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/10/2021	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0029	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-866-399-0928				HMO - Health Maintenance Organization		C	Dallas
H0029	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0034	Automated TrOOP Balance Transfer Contact	Senior Data and Reporting Analyst		Arinsburg	Valerie		1-480-624-9349					arinsbergv@magellanhealth.com	Magellan Rx Management	2520 Industrial Row Drive	Troy	MI	48084	10/05/2020	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Best Available Evidence Contact	VP, Compliance and Regulatory Affairs	Mr.	Dehm	Karl		1-845-503-0569					kdehm@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	10/18/2019	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Chief Financial Officer	Chief Finance Officer	Mr.	Brach	Joel		1-845-503-0925					jbrach@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	02/19/2021	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	CMS Casework Communication Contact	VP, Compliance and Regulatory Affairs	Mr.	Dehm	Karl		1-845-503-0569					kdehm@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	12/07/2022	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Coordination of Benefits Contact	Comptroller, Medicare	Ms.	Hammelburger	Rivka		1-845-503-0990					rhammelburger@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	04/26/2022	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Customer Service Operations Contact	VP, Operations	Ms.	Manning	Emily		1-845-503-0535					emanning@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	10/05/2020	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Government Relations Contact	VP, Compliance and Regulatory Affairs		Dehm	Karl		1-845-503-0569					kdehm@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	10/18/2019	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Hospice Contact	VP, Operations	Ms.	Manning	Emily		1-845-503-0535					emanning@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	12/07/2022	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Medicare Compliance Officer	VP, Compliance and Regulatory Affairs	Mr.	Dehm	Karl		1-845-503-0569					kdehm@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	10/18/2019	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Part D Exceptions Contact	Director, Compliance	Ms.	Adler	Blimy							badler@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	12/07/2021	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active	1-845-503-0507				HMO - Health Maintenance Organization		C	New York
H0034	Pharmacy Network Management Contact	VP, Compliance and Regulatory Affairs		Dehm	Karl		1-845-503-0569					kdehm@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	10/18/2019	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Pharmacy Technical Help Desk Contact	Manager, Clinical Pharmacy Operations		DiBiase	Joe							JDiBiase@magellanhealth.com	Magellan Rx Management	2520 Industrial Row Drive	Troy	MI	48084	01/06/2020	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active	1-800-424-4437				HMO - Health Maintenance Organization		C	New York
H0034	Plan to Plan Reconciliation Contact	Comptroller, Medicare		Hammelburger	Rivka		1-845-503-0990	570				rhammelburger@hamaspikchoice.org	58 Route 59, Suite #1		Monsey	NY	10952	12/07/2022	2023	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0035	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-303-869-4664				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Chief Financial Officer	CFO	Ms.	Gutierrez	Barbara		1-303-869-4664				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-720-789-6054				1-303-996-1600	epeak@myinnovage.com	750 E 6th St		Richmond	VA	23224	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Customer Service Operations Contact	Regional Director of Quality	Mr.	Harrington	Paige		1-303-859-2096				1-303-996-1600	pharrington@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Government Relations Contact	Senior Vice President, Government	Ms.	Dahan	Beverley		1-303-869-4664				1-303-996-1600	bdahan@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Medicare Compliance Officer	VP of Pharmacy	Ms.	Chase	Darla		1-720-974-6785				1-303-996-1614	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Part D Exceptions Contact	Pharmacy Director	Ms.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending	1-720-974-6785				PACE - Nat		C	San Francisco
H0035	Pharmacy Network Management Contact	VP of Pharmacy	Ms.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Pharmacy Technical Help Desk Contact	VP of Pharmacy	Ms.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending	1-720-974-6785				PACE - Nat		C	San Francisco
H0035	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-720-974-6031				1-303-996-1600	AKizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0062	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/10/2021	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	05/06/2022	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	05/06/2022	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/10/2021	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0062	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/10/2021	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0062	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H0062	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0074	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	05/26/2022	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	01/29/2021	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	05/11/2022	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H0074	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0074	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H0074	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	05/11/2022	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H0088	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0088	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H0088	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0104	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Coordinator		Stevens	Andrew		1-205-220-2593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/13/2022	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Best Available Evidence Contact	Sr. Business Analyst		Johnson	Geraldine		1-205-220-6077					gejohnson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/05/2022	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Chief Financial Officer	SVP & Chief Financial Officer	Mr.	Carden	Noel		1-205-220-7741					ncarden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2022	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	CMS Casework Communication Contact	Senior Compliance Analyst		Jones	Kimberly		1-205-220-7077					kwjones@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/30/2021	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Coordination of Benefits Contact	Manager Claims Processing		Davis	Lori		1-205-220-6265					Lori.Davis@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/11/2018	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Customer Service Operations Contact	Dept Manager Customer Service		Pearson	Latreta		1-205-220-7905					llpearson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/13/2021	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Government Relations Contact	Manager Product Management	Mrs	Kullman	Christy	M	1-205-220-5915					CKullman@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/07/2019	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Hospice Contact	Pharmacy Operations Coordinator		Stevens	Andrew		1-205-220-2593					WStevens@BCBSAL.ORG	450 Riverchase Parkway East		Birmingham	AL	35244	04/16/2019	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Medicare Compliance Officer	Manager Corporate Compliance	Mr.	Gregg	Roger		1-205-220-7480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/24/2009	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Part D Exceptions Contact	Regulatory Director		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/08/2021	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	1-800-693-6651				PPO - BBA		C	Atlanta
H0104	Pharmacy Network Management Contact	Pharmacy Services Mgr		Matthews	Ginny		1-205-220-6558				1-205-403-4052	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0104	Pharmacy Technical Help Desk Contact	Pharmacy Services Mgr		Matthews	Ginny							Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	1-877-878-8668				PPO - BBA		C	Atlanta
H0104	Plan to Plan Reconciliation Contact	Sr. Analyst-Cash Management		Buford	Julie		1-205-220-7316					julie.buford@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	12/08/2021	2023	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Local CCP	Blue Cross and Blue Shield of Alabama	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H0105	Automated TrOOP Balance Transfer Contact	Program Director	Mr.	Williams	Rob		1-803-268-5306				1-803-268-5302	rob.williams@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	11/30/2022	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	Best Available Evidence Contact	Program Director	Mr.	Williams	Rob		1-803-268-5306				1-803-268-5302	rob.williams@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	11/30/2022	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	Chief Financial Officer	CFO	Mrs.	Phillips	Tricia		1-803-534-1212	1573			1-803-535-1540	tricia.phillips@theoakssc.com	PO Drawer 327		Orangeburg	SC	29116	11/30/2022	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	CMS Casework Communication Contact	LPN, Quality Improvement Coordinator	Mrs	Nichols	Kathy		1-803-534-1212	5326			1-803-268-5302	kathy.nichols@theoakssc.com	153 Founders Court		Orangeburg	SC	29118	11/06/2020	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	Coordination of Benefits Contact	Program Director	Mr.	Williams	Rob		1-803-268-5306				1-803-268-5302	rob.williams@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	11/30/2022	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	Customer Service Operations Contact	LPN, Quality Improvement Coordinator	Mrs	Nichols	Kathy		1-803-534-1212	5326			1-803-268-5302	kathy.nichols@theoakssc.com	153 Founders Court		Orangeburg	SC	29118	11/06/2020	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	Government Relations Contact	PACE Program Director	Mr	Williams	Rob		1-803-534-1212	5306			1-803-268-5302	rob.williams@theoakssc.com	153 Founders Court		Orangeburg	SC	29118	10/27/2021	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	Medicare Compliance Officer	CFO	Mrs.	Phillips	Tricia		1-803-534-1212	1573			1-803-535-1540	tricia.phillips@theoakssc.com	PO Drawer 327		Orangeburg	SC	29116	11/30/2022	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	Part D Exceptions Contact	Program Director	Mr.	Williams	Rob						1-803-268-5302	rob.williams@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	11/30/2022	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active	1-803-268-5306				PACE - Nat		C	Atlanta
H0105	Pharmacy Network Management Contact	Pharmacist/Owner  Grove Park Pharmacy	Mr	Thompson	Charles		1-803-536-0007					grovepark@earthlink.net	1324 Chestnut Street		Orangeburg	SC	29118	04/25/2016	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0105	Pharmacy Technical Help Desk Contact	Pharmacist/Owner  Grove Park Pharmacy	Mr	Thompson	Charles						1-803-268-5302	grovepark@earthlink.net	1324 Chestnut Street		Orangeburg	SC	29118	12/18/2020	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active	1-877-505-3131				PACE - Nat		C	Atlanta
H0105	Plan to Plan Reconciliation Contact	CFO	Mrs.	Phillips	Tricia		1-803-534-1212	1573			1-803-535-1540	tricia.phillips@theoakssc.com	P O Drawer 327		Orangeburg	SC	29116	11/30/2022	2023	Orangeburg Senior Helping Center, LLC	National PACE	Orangeburg Senior Helping Center: A PACE Healthcare Program	National PACE		Orangeburg Senior Helping Center, LLC	796	Yes	Active					PACE - Nat		C	Atlanta
H0107	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	03/25/2019	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				PPO - BBA		C	Denver
H0107	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0107	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				PPO - BBA		C	Denver
H0107	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H0111	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					Denethia.Steadman@wellcare.com	8735 Henderson Rd		Tampa	FL	33436	05/17/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	05/17/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H0111	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0111	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H0111	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0112	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mr	Chae	Hong	S	1-561-678-5753				1-561-689-8718	HChae@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	Best Available Evidence Contact	Chief Financial Officer	Mr	Chae	Hong	S	1-561-678-5753				1-561-689-8718	HChae@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	Chief Financial Officer	Chief Financial Officer	Mr	Chae	Hong	S	1-561-687-5753				1-561-683-4556	hchae@MorseLife.org	4847David S. Mack  Dr.		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	CMS Casework Communication Contact	Senior VP Home & Community Based Services	Dr.	Sadowsky	Alan	D	1-561-687-5745				1-561-683-4556	ASadowsky@MorseLife.org	4847 David S. Mack  Dr.		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	Coordination of Benefits Contact	Chief Financial Officer	Mr	Chae	Hong	S	1-561-678-5753				1-561-689-8718	HChae@MorseLife.org	4847 David S. Mack  Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	Customer Service Operations Contact	Senior VP Home & Community Based Services	Dr.	Sadowsky	Alan	D	1-561-687-5745				1-561-683-4556	ASadowsky@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	Government Relations Contact	Senior VP Home & Community Based Services	Dr.	Sadowsky	Alan	D	1-561-687-5745				1-561-683-4556	ASadowsky@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	Medicare Compliance Officer	Senior VP Home & Community Based Services	Dr.	Sadowsky	Alan	D	1-561-687-5745				1-561-683-4556	ASadowsky@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	Part D Exceptions Contact	Senior VP Home & Community Based Services	Dr.	Sadowsky	Alan	D					1-561-683-4556	ASadowsky@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active	1-888-616-0707				PACE - Nat		C	Atlanta
H0112	Pharmacy Network Management Contact	Chief Financial Officer	Mr	Chae	Hong	S	1-561-678-5753				1-561-689-8718	HChae@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0112	Pharmacy Technical Help Desk Contact	Chief Financial Officer	Mr	Chae	Hong	S					1-561-689-8718	HChae@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active	1-888-616-0707				PACE - Nat		C	Atlanta
H0112	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Chae	Hong	S	1-561-678-5753				1-561-689-8718	HongC@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2023	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0137	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment and Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Best Available Evidence Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931				randrade@commonwealthcare.org	30 Winter St		Boston	MA	02108	02/05/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Chief Financial Officer	Chief Financial Officer	Ms.	Hamilton	Mary		1-857-327-1953					mahamilton@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	CMS Casework Communication Contact	Director, Appeals& Grievances		Schenk	Tyrone		1-857-327-3320				1-857-453-4517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Coordination of Benefits Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931			1-617-426-3109	randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/05/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Customer Service Operations Contact	VP, Customer Service		Habib	Fred		1-617-426-0600	1504			1-617-426-3097	fhabib@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/13/2019	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Government Relations Contact	VP, Government Relations		Preede	Ken		1-617-426-0600	51412				kpreede@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/30/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Hospice Contact	Palliative Care Medical Director		Ragland	Julia		1-781-525-4203					JRagland@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	10/04/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	Lavallee	Katherine		1-617-947-5780					KLavalee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/01/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Part D Exceptions Contact	Sr. Manager, Clinical Prior Auth		LeClair	Christophe						1-920-221-4676	Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/25/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877				Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@Navitus.com	361 Integrity Drive		Madison	WI	53713	03/25/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Pharmacy Technical Help Desk Contact	Sr. Mgr, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	53713	03/25/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877	4224			Demo Risk Option C	MMP HMO Demo	C	Boston
H0137	Plan to Plan Reconciliation Contact	Accounts Receivable Coordinator		Newman	Elaine		1-617-426-0600	52580				enewman@commonwealthcare.org	30 Winter St		Boston	MA	02108	08/25/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Demo	Commonwealth Care Alliance Massachusetts	Medicare-Medicaid Plan HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H0154	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Management		Tressler	Damon		1-480-391-4702				1-480-314-6023	Damon.tressler@caremark.com	9501 E Shea Blvd.		Scottsdale	AZ	85260	01/10/2013	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Best Available Evidence Contact	Director, Medicare Enrollment	Ms.	Murphree	Cindy	J	1-205-558-7557				1-205-449-7628	cmurphree@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	02/10/2020	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Chief Financial Officer	CFO	Ms.	Watkins	Letitia		1-205-558-7480				1-205-939-1748	lwatkins@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	CMS Casework Communication Contact	Supervisor, Appeals and Grievances	Mr.	McReynolds	Nia		1-205-558-7410				1-205-558-7414	niamcreynolds@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	02/10/2020	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Coordination of Benefits Contact	Director of Claims	Ms.	Jones-Marshall	Beverly		1-205-558-7690				1-205-558-7546	bjmarshall@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/31/2015	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Customer Service Operations Contact	Manager, Medicare Member Services	Ms.	Mize	Tracy	B	1-205-558-7591				1-205-558-7414	tmize@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	02/10/2020	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Government Relations Contact	Chief  Administrative Officer	Ms.	Yates	Libba		1-205-558-7406				1-205-939-1748	lyates@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/30/2015	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Hospice Contact	Supervisor - Clinical Pharmacy Administration		Popwell	Chris		1-205-558-7621				1-205-933-1232	cpopwell@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	06/10/2019	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Medicare Compliance Officer	Compliance Officer	Mr.	Cutcliffe	Charles		1-205-558-7606				1-205-449-7626	ccutcliffe@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35205	07/01/2013	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Part D Exceptions Contact	Supervisor - Clinical Pharmacy Administration		Popwell	Chris						1-205-933-1232	cpopwell@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	06/10/2019	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active	1-800-633-1542				HMO - Health Maintenance Organization		C	Atlanta
H0154	Pharmacy Network Management Contact	Director, Network Systems		Tressler	Damon		1-480-391-4702				1-480-314-6324	Damon.tressler@caremark.com	9501 E. Shea Blvd., MC080		Scottsdale	AZ	85260	01/10/2013	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0154	Pharmacy Technical Help Desk Contact	Advisor/Project Manager, Medicare D	Mr.	Horner	Bob						1-480-314-6077	doug.halbert@caremark.com	9501 E Shea Blvd., MC 005		Scottsdale	AZ	85260	02/19/2013	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Atlanta
H0154	Plan to Plan Reconciliation Contact	Pharmacy Analyst	Ms.	Holsombeck	Susan		1-205-558-7551				1-205-933-1232	sholsombeck@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	01/07/2016	2023	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0169	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/10/2019	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/21/2018	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/10/2019	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/07/2020	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/10/2019	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H0169	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0169	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H0169	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDWEST, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0174	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0174	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0174	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H0174	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0192	Automated TrOOP Balance Transfer Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		1-215-937-5325					nortiz@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	12/30/2020	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		1-484-497-1171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/27/2019	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Chief Financial Officer	Chief Financial Officer	Mr.	Burgoyne	Michael		1-215-937-8875					mburgoyne@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	100 Stevens Drive	Philadelphia	PA	19113	06/20/2019	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	CMS Casework Communication Contact	Medicare QA Contract Acct Mgr	Ms.	Fine	Nicole		1-484-496-7479					nfine@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	10/17/2022	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Coordination of Benefits Contact	Manager, Provider Network Oversight	Ms.	Williams	Kathy		1-843-746-7499					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/09/2022	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		1-267-298-1794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	07/29/2022	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Government Relations Contact	Director, Public Policy		Cozzo	Mr.Steven		1-215-937-8236					scozzo@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	11/19/2021	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Hospice Contact	Directory of Pharmacy	Ms.	Shepard	Jen		1-215-937-8685					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	07/29/2022	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Dupre	Colleen		1-203-506-8413					cdupre@selecthealthofsc.com	AmeriHealth Caritas Family of Companies	200  Stevens Drive	Philadelphia	PA	19113	01/27/2022	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Part D Exceptions Contact	Dir., Pharmacy Uitlization Management	Mr.	Bonko	Gerald						1-215-863-5100	gbonko@performrx.com	PerformRx	200 Stevens Dr.	Philadelphia	PA	19113	12/22/2016	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-215-863-6483				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Pharmacy Network Management Contact	Director	Ms.	Leal	Avelina		1-215-863-6540					aleal@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	12/30/2020	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Pharmacy Technical Help Desk Contact	Director, Service Operations	Ms.	Leal	Avelina								PerformRx	200 Stevens Drive	Philadelphia	PA	19113	11/05/2019	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-855-328-0011				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0192	Plan to Plan Reconciliation Contact	Director, Medicare Performance Management	Mr.	Kindred	Amanda		1-248-404-5991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	AMERIHEALTH MICHIGAN, INC.	Demo	AmeriHealth Caritas VIP Care Plus	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0201	Automated TrOOP Balance Transfer Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	Best Available Evidence Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	Chief Financial Officer	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	CMS Casework Communication Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	Coordination of Benefits Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	Customer Service Operations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	Government Relations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	Medicare Compliance Officer	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	Part D Exceptions Contact	CFO		Prentis	Kristin							kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending	1-732-806-3224				PACE - Nat		C	New York
H0201	Pharmacy Network Management Contact	Executive Director	Mrs	Runyon	Bobbi		1-732-592-3400					brunyon@beaconpace.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0201	Pharmacy Technical Help Desk Contact	Executive Director	Mrs	Runyon	Bobbi							brunyon@beaconpace.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending	1-732-592-3400				PACE - Nat		C	New York
H0201	Plan to Plan Reconciliation Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	11/30/2022	2023	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	Beacon of Life Central NJ, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H0216	Automated TrOOP Balance Transfer Contact	Health Plan Manager	Mrs.	Boyle	Amanda		1-402-829-2993				1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	Best Available Evidence Contact	Health Plan Manager	Mrs.	Boyle	Amanda		1-402-829-2993				1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	Chief Financial Officer	CFO	Mr	Bear	Scott		1-402-829-2922				1-402-829-2939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	03/22/2018	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	CMS Casework Communication Contact	VP of PACE Operations	Mrs	Butterfield	April		1-402-829-2900				1-402-829-2998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	Coordination of Benefits Contact	Health Plan Manager	Mrs.	Boyle	Amanda		1-402-829-2993				1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	Customer Service Operations Contact	VP of PACE Operations	Mrs	Butterfield	April		1-402-829-2900				1-402-829-2998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	Government Relations Contact	Corporate Compliance Officer	Mr	Kuenning	Adam		1-402-829-2931					akuenning@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	09/17/2019	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	Medicare Compliance Officer	Corporate Compliance Officer	Mrs	Durbin	Tracy		1-402-829-2968				1-402-829-2939	Tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/22/2021	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	Part D Exceptions Contact	Health Plan Manager	Mrs.	Boyle	Amanda						1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active	1-000-000-0000				PACE - Nat		C	Kansas City
H0216	Pharmacy Network Management Contact	Medical Director	Mr	Vossen	Adam		1-402-829-6950				1-402-829-2998	avossen@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/16/2018	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0216	Pharmacy Technical Help Desk Contact	Health Plan Manager	Mrs.	Boyle	Amanda						1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active	1-000-000-0000				PACE - Nat		C	Kansas City
H0216	Plan to Plan Reconciliation Contact	Health Plan Manager	Mrs.	Boyle	Amanda		1-402-829-2993				1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H0235	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mr	Shapiro	Aaron		1-260-745-1200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	Best Available Evidence Contact		Mr	Shapiro	Aaron		1-260-745-1200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	Chief Financial Officer		Mr	Shapiro	Aaron		1-260-745-1200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	12/20/2018	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	CMS Casework Communication Contact	VP of PACE Operations	Ms	Hougham	Katie		1-260-469-4148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	Coordination of Benefits Contact	VP of PACE Operations	Ms	Hougham	Katie		1-260-469-4148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	Customer Service Operations Contact	Chief Operating Officer		Widner	Maureen		1-260-745-1200	285				mwidner@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	12/20/2018	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	Government Relations Contact	VP of PACE Operations	Ms	Hougham	Katie		1-260-469-4148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	Medicare Compliance Officer	VP of PACE Operations	Mr	Hougham	Katie		1-260-469-4148	316				katie.hougham@pacenein.org	2927 Lake Ave		Fort Wayne	IN	46805	09/28/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	Part D Exceptions Contact	VP of PACE Operations		Hougham	Katie							katie.hougham@pacenein.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active	1-260-469-4148	643			PACE - Nat		C	Kansas City
H0235	Pharmacy Network Management Contact	VP of PACE Operations	Ms	Hougham	Katie		1-260-469-4148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0235	Pharmacy Technical Help Desk Contact	VP of PACE Operations		Hougham	Katie							katie.hougham@pacenein.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active	1-260-469-4148	643			PACE - Nat		C	Kansas City
H0235	Plan to Plan Reconciliation Contact		Mr	Shapiro	Aaron		1-260-745-1200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2023	PACE OF NORTHEAST INDIANA, LLC	National PACE	PACE of Northeast Indiana, LLC	National PACE		Aging & In-Home Services of Northeast Indiana, Inc	743	Yes	Active					PACE - Nat		C	Kansas City
H0242	Automated TrOOP Balance Transfer Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	09/13/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	Best Available Evidence Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	09/13/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	Chief Financial Officer	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	09/13/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	CMS Casework Communication Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/15/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	Coordination of Benefits Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	09/13/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	Customer Service Operations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/15/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	Government Relations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/15/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	Medicare Compliance Officer	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/15/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	Part D Exceptions Contact	CFO		Prentis	Kristin							kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	09/13/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending	1-732-806-3224				PACE - Nat		C	Atlanta
H0242	Pharmacy Network Management Contact	Executive Director	Mrs	Runyon	Bobbi		1-732-592-3400					brunyon@beaconpace.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	09/15/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0242	Pharmacy Technical Help Desk Contact	Executive Director	Mrs	Runyon	Bobbi							brunyon@beaconpace.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	09/15/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending	1-732-592-3400				PACE - Nat		C	Atlanta
H0242	Plan to Plan Reconciliation Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	09/13/2022	2023	BEACON OF LIFE FLORIDA, LLC	National PACE	Beacon of LIfe Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0247	Automated TrOOP Balance Transfer Contact	PACE Clinical Pharmacist	Dr.	Lee	Jen		1-541-474-8000	8157			1-541-474-3296	jen.lee@allcarehealth.com	2166 NW Vine Street		Grants Pass	OR	97526	12/29/2021	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	Best Available Evidence Contact	Clinical Pharmacist	Dr.	Lee	Jen		1-541-474-8000	8157			1-541-474-3296	jen.lee@allcarehealth.com	2166 NW Vine Street		Grants Pass	OR	97526	12/29/2021	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	Chief Financial Officer	CFO	Mr.	Woodin	Matthew	P	1-541-471-4106				1-541-471-1524	matthew.woodin@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/07/2022	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	CMS Casework Communication Contact	Director of Quality		Matola	Laura		1-541-471-4106				1-541-471-1524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/13/2020	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	Coordination of Benefits Contact	VP Claims Administration & Business Services		Gillespie	Lori		1-541-471-4106	5111			1-541-956-1674	lori.gillespie@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	07/01/2020	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	Customer Service Operations Contact	Operations Manager	Ms.	Bullion	Alyssa		1-541-474-8000	8165			1-541-474-3296	alyssa.bullion@allcarehealth.com	2166 NW Vine Street		Grants Pass	OR	97526	12/29/2021	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	Government Relations Contact	CNO, PACE Executive Director	Ms.	Silva	Deneen		1-541-474-8000	8309			1-541-474-3296	deneen.silva@allcarehealth.com	2166 NW Vine Street		Grants Pass	OR	97526	12/29/2021	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Ackerman	Cynthia	A	1-541-471-4106	8115			1-541-471-1524	cynthia.ackerman@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	12/02/2020	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	Part D Exceptions Contact	PACE Clinical Pharmacist	Dr.	Lee	Jen						1-541-474-3296	jen.lee@allcarehealth.com	2166 NW Vine Street		Grants Pass	OR	97526	12/29/2021	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active	1-844-950-7223	8157			PACE - Nat		C	Seattle
H0247	Pharmacy Network Management Contact	PACE Clinical Pharmacist	Dr.	Lee	Jen		1-541-474-8000	8157			1-541-474-3296	jen.lee@allcarehealth.com	2166 NW Vine Street		Grants Pass	OR	97526	12/29/2021	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0247	Pharmacy Technical Help Desk Contact	PACE Clinical Pharmacist	Dr.	Lee	Jen						1-541-474-3296	jen.lee@allcarehealth.com	2166 NW Vine Street		Grants Pass	OR	97526	12/29/2021	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active	1-844-950-7223	8157			PACE - Nat		C	Seattle
H0247	Plan to Plan Reconciliation Contact	Controller		Ross	Andi		1-541-471-4106				1-541-471-1524	andi.ross@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/13/2020	2023	ALLCARE PACE, LLC	National PACE	AllCare PACE, LLC	National PACE		AllCare Health, Inc.	660	Yes	Active					PACE - Nat		C	Seattle
H0251	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/07/2020	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H0251	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0251	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H0251	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/14/2019	2023	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0270	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/05/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H0270	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0270	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H0270	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0271	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	03/31/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H0271	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0271	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H0271	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/14/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0292	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H0292	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H0292	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0294	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	03/31/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H0294	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0294	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H0294	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/14/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0302	Automated TrOOP Balance Transfer Contact			Esp	Brian		1-858-790-6445					partdcat@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/12/2013	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Best Available Evidence Contact	Mgr- Medicare Enrollment		Ramirez	Michelle		1-602-916-8404					michelle.ramirez@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	05/28/2020	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Chief Financial Officer	Chief Financial Officer	Mr.	El-Tawil	Mark		1-602-864-5700					mark.el-tawil@azblue.com	8220 N 23rd Ave	MS C410	Phoenix	AZ	85021	01/13/2020	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	CMS Casework Communication Contact	Director, Corporate and Medicare Compliance		Moore	Veronica		1-602-336-7600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/28/2020	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Coordination of Benefits Contact	Mgr- Medicare Finance		Nguyen	Peter		1-602-916-8506					peter.nguyen@azblue.com	10835 N 25th Ave		Phoenix	AZ	85029	05/29/2020	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Customer Service Operations Contact	Staff VP, MA Ops & FEP Progs		Setzer	Stephanie	S	1-602-864-5726					stephanie.setzer@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	06/08/2022	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Government Relations Contact	VP & General Manager Medicare & FEP		Bowers	Krista		1-818-219-7755					krista.bowers@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	01/12/2022	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Hospice Contact	Sr Health Plan Rx Specialist		Norman	Laci		1-602-916-8577					laci.norman@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	05/29/2020	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Medicare Compliance Officer	Director, Corporate and Medicare Compliance	Mrs.	Moore	Veronica		1-602-336-7600				1-602-864-3152	veronica.moore@azblue.com	8220 N 23rd Avenue		Phoenix	AZ	85021	02/11/2021	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Part D Exceptions Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Weideman	Stacy							Stacy.Weideman@azblue.com	10835 N 25th Ave. Ste 108		Phoenix	AZ	85029	10/22/2022	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-602-864-4391				HMO - Health Maintenance Organization		C	San Francisco
H0302	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	MedImpact	10181 Scripps Gateway Ct .	San Diego	CA	92131	12/03/2013	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0302	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct .		San Diego	CA	92131	11/16/2022	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-877-403-6038				HMO - Health Maintenance Organization		C	San Francisco
H0302	Plan to Plan Reconciliation Contact	Director, Financial Reporting		Acquafredda	Brandy		1-602-864-4683				1-602-864-5308	brandy.acquafredda@azblue.com	PO Box 81049		Phoenix	AZ	85069	03/09/2020	2023	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/07/2020	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H0321	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0321	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H0321	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/14/2019	2023	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0332	Automated TrOOP Balance Transfer Contact	Director of Pharmacy, Health Plan Services		Gandhi	Kirti		1-713-442-5519				1-713-442-5105	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	01/25/2021	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Best Available Evidence Contact	Director Service Operations		Garcia	Shelly		1-713-442-9502				1-713-442-5212	shelly.garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77587	05/07/2019	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Chief Financial Officer	Chief Financial Officer	Mr.	Kumar	Saurabh		1-713-442-4873				1-713-442-0799	saurabh.kumar@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	07/15/2021	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	CMS Casework Communication Contact	Director, Service Operations		Garcia	Shelly		1-713-442-9502				1-713-442-5212	shelly.garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	10/26/2017	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Coordination of Benefits Contact	Director of Pharmacy, Health Plan Services		Gandhi	Kirti		1-713-442-5519				1-713-442-5105	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	01/25/2021	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Customer Service Operations Contact	Director Member Services & Enrollment		Garcia	Shelly		1-713-442-9502				1-713-442-5212	shelly.garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	05/07/2019	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Government Relations Contact	Sr. Director, Medicare Compliance	Mr.	Wilson	Thomas		1-904-669-8710				1-904-669-8710	Thomas.Wilson@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	08/25/2022	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Hospice Contact	VP of Health Plan Services/COO		Jonathan	Denise		1-713-442-5592					Denise.Jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/28/2022	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Medicare Compliance Officer	Sr. Director, Medicare Compliance	Mr.	Wilson	Thomas		1-904-669-8710				1-904-669-8710	Thomas.Wilson@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	08/25/2022	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Part D Exceptions Contact	Director of Pharmacy, Health Plan Services		Gandhi	Kirti						1-713-442-4848	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	01/25/2021	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-844-541-8507				HMO - Health Maintenance Organization		C	Dallas
H0332	Pharmacy Network Management Contact	Sr Manager - Networks		Johnson	Tanner		1-480-202-3593					tanner.johnson@cvshealth.com	9501 E. Shea Blvd MC 049		Scottsdale	AZ	85260	01/04/2021	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0332	Pharmacy Technical Help Desk Contact	Advisor - Client Operations		Browning	Jennifer							jennifer.browning@cvshealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	01/04/2021	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-888-970-0914				HMO - Health Maintenance Organization		C	Dallas
H0332	Plan to Plan Reconciliation Contact	Director of Pharmacy, Health Plan Services		Gandhi	Kirti		1-713-442-5519				1-713-442-5105	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	01/25/2021	2023	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0336	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0336	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Demo	Humana	Medicare-Medicaid Plan HMO/HMOPOS		Humana Inc.	128	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0342	Automated TrOOP Balance Transfer Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Best Available Evidence Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Chief Financial Officer	SVP Chief Financial Officer	Mr.	Kurpad	Umesh		1-781-612-1000	84968				umesh.kurpad@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	CMS Casework Communication Contact	Director, Appeals & Grievances	Ms.	Evans	Kathleen		1-617-972-9400	87204				kathleen.evans@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Coordination of Benefits Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Customer Service Operations Contact	Manager, Member Services	Ms.	Villatoro	Yesly		1-781-612-1000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Government Relations Contact	Chief Government Affairs Officer	Ms.	Lewis	Kristin		1-781-612-1000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Hospice Contact	Manager, Pharmacy Operations & Programs	Ms.	MacAuley	Jacqueline		1-781-612-1000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Taylor	James		1-781-612-1000	88089				james.taylor@point32health.org	1 Wellness Way		Canton	MA	02021	01/04/2023	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active	1-781-612-1000	82370			PPO - BBA		C	Boston
H0342	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/09/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	12/08/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active	1-855-524-0380				PPO - BBA		C	Boston
H0342	Plan to Plan Reconciliation Contact	Manager, Finance Operations	Ms.	Olson	Rachel		1-781-612-1000	84360				rachel.olson@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0351	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/10/2021	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1850 W. Rio Salado Parkway		Tempe	AZ	85281	07/19/2022	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/10/2021	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0351	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/10/2021	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0351	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H0351	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0354	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/11/2021	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Best Available Evidence Contact	Enrollment/Billing Sr Manager	Mrs	Rice	Sarah		1-480-215-9884					Sarah.Rice2@cigna.com	25501 N Norterra Pkwy		Phoenix	AZ	85085	02/09/2022	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O'Donnell Street		Baltimore	MD	21224	01/07/2021	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Coordination of Benefits Contact	Enrollment/Billing Sr Manager	Mrs	Rice	Sarah		1-480-215-9884					Sarah.Rice2@cigna.com	25501 N Norterra Pkwy		Phoenix	AZ	85085	02/09/2022	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Customer Service Operations Contact	Customer Service Manager		Soltis	Mike		1-623-806-3361					Michael.Soltis@Cigna.com	25501 Norterra Pkwy		Phoenix	AZ	85085	03/11/2021	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Hospice Contact	Enrollment/Billing Sr Manager	Mrs	Rice	Sarah		1-480-215-9884					Sarah.Rice2@cigna.com	25501 N Norterra Pkwy		Phoenix	AZ	85085	02/09/2022	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	01/07/2021	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H0354	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H0354	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	06/14/2021	2023	CIGNA HEALTHCARE OF ARIZONA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Automated TrOOP Balance Transfer Contact			Rush	Jamie		1-561-690-1134					ESITroopTransfer@express-scripts.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Best Available Evidence Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N 107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Chief Financial Officer		Mr.	Granow	Les		1-561-444-0709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	CMS Casework Communication Contact			Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Coordination of Benefits Contact		Ms.	Burdelik	Dawn		1-561-815-3729					dawn.burdelik@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Customer Service Operations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Government Relations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Hospice Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Medicare Compliance Officer		Ms.	Lacey	Jennifer		1-813-367-7169					Jennifer.lacey@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						1-888-235-8551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-204-0016				HMO - Health Maintenance Organization		C	New York
H0363	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		1-800-204-0016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						1-888-235-8551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H0363	Plan to Plan Reconciliation Contact		Ms.	Zhai	Vicky		1-561-632-8915					Vicky.Zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0390	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Ms.	Weberg	Donna		1-269-408-4360					donnaweberg@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	08/11/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	Best Available Evidence Contact	CEO	Mr.	Schlaman	James		1-269-408-4375				1-269-408-4340	jimschlaman@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	11/23/2020	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	Chief Financial Officer	Chief Financial Officer	Ms.	Weberg	Donna		1-269-408-4360				1-269-408-4340	donnaweberg@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	08/11/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	CMS Casework Communication Contact	Compliance Officer	Mr.	Erny	Corey		1-269-408-4359				1-269-408-4340	coreyerny@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/16/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	Coordination of Benefits Contact	Chief Financial Officer	Ms.	Weberg	Donna		1-269-408-4360				1-269-408-4340	donnaweberg@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	08/11/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	Customer Service Operations Contact	Center Manager		Gibson	Rhonda		1-269-408-4302					rhondagibson@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	08/08/2018	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	Government Relations Contact	CEO	Mr.	Schlaman	James		1-269-408-4375				1-269-408-4340	jimschlaman@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	11/23/2020	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	Medicare Compliance Officer	Compliance Officer	Mr.	Erny	Corey		1-269-408-4359				1-269-408-4340	coreyerny@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/16/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	Part D Exceptions Contact	Compliance Officer	Mr.	Erny	Corey						1-269-408-4340	coreyerny@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/16/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active	1-855-243-8876				PACE - Nat		C	Chicago
H0390	Pharmacy Network Management Contact	Chief Financial Officer	Ms.	Weberg	Donna		1-269-408-4360				1-269-408-4340	donnaweberg@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	08/11/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0390	Pharmacy Technical Help Desk Contact	Compliance Officer	Mr.	Enry	Corey						1-269-408-4340	coreyerny@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/16/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active	1-855-243-8876				PACE - Nat		C	Chicago
H0390	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Weberg	Donna		1-269-408-4360				1-269-408-4340	donnaweberg@paceswmi.org	2900 Lakeview		Saint Joseph	MI	49085	08/11/2022	2023	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Chicago
H0422	Automated TrOOP Balance Transfer Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	08/16/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Best Available Evidence Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					mjohnson4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/16/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Chief Financial Officer	SVP and Chief Financial Officer	Ms.	Monsrud	Beth		1-612-676-3217				1-612-676-6501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/09/2018	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	CMS Casework Communication Contact	A&G Regulatory and Compliance Specialist		Wood	Nakia		1-612-294-5668					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Coordination of Benefits Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Customer Service Operations Contact	Customer Service Workforce Manager		Vang	Pakou		1-612-676-3585					pvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	03/08/2018	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Government Relations Contact	Federal Government Relations Specialist		Vang	Julie		1-612-294-5654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/30/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Hospice Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051					pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	McMahon	Jane		1-612-456-7817					federalgrleadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	07/27/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Part D Exceptions Contact	Vice President Pharmacy Management		Mitsch	Patrick						1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	1-612-294-5051				HMO - Health Maintenance Organization		C	Chicago
H0422	Pharmacy Network Management Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0422	Pharmacy Technical Help Desk Contact	Director, Customer Service		Warren	Mark							mwarren@express-scripts.com	6625 West 78th Street		Minneapolis	MN	55439	11/30/2020	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H0422	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		1-612-676-3213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/09/2018	2023	UCARE HEALTH, INC.	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0423	Automated TrOOP Balance Transfer Contact	Medicare Part D Operations Manager	Mr.	Oh	Benjamin		1-212-908-3131				1-212-908-8603	ohben@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Best Available Evidence Contact	Medicare Operations Regulatory Analyst		Vilchez	Erika		1-212-908-3150				1-212-908-8603	vilchee@metroplus.org	50 Water Street	12th floor	New York	NY	10004	07/16/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Chief Financial Officer	Chief Administrative Officer	Ms.	Leverich	Lauren		1-212-908-8592					LEVERL@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	CMS Casework Communication Contact	Senior Director of Call Center Operations	Ms.	Bartley	Kenesha		1-212-908-3643				1-212-908-8701	bartleyk@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	09/19/2022	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Coordination of Benefits Contact		Mr.	Ansari	Zia	M	1-212-908-3124					ansarmo@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	09/19/2022	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Customer Service Operations Contact	Senior  Director of Call Center Operations	Ms.	Bartley	Kenesha		1-212-908-3643				1-212-908-8705	bartleyk@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/09/2022	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Government Relations Contact	President & Chief Executive Officer	Dr.	Schwartz	Talya		1-212-908-8569				1-212-908-8667	schwata@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Hospice Contact	Deputy Director Pharmacy Department		Suchdeve	Swati		1-212-908-3765					suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/17/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Medicare Compliance Officer	Director of Regulatory Compliance	Ms.	Francois	Jackedja		1-212-908-3329				1-212-908-3013	FRANCOJ@metroplus.org	50 Water Street	12th floor	New York	NY	10004	07/19/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Part D Exceptions Contact	Deputy Director of Pharmacy	Ms.	Suchdeve	Swati							suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	1-212-908-3765				HMO - Health Maintenance Organization		C	New York
H0423	Pharmacy Network Management Contact	Director of Pharmacy		Patel	Suzana		1-212-908-3014				1-212-908-3014	patelsu@metroplus.org	50 Water St	7th Floor	New York	NY	10004	07/12/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0423	Pharmacy Technical Help Desk Contact	Pharmacist	Mr.	Curtis	Kirk							kirk.curtis@cvshealth.com	42121 E. Cotton Center Blvd.		Phoenix	AZ	85040	12/05/2019	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H0423	Plan to Plan Reconciliation Contact	Finance Analyst	Ms.	Goyal	Anandita		1-212-908-8807					goyalan@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	08/31/2021	2023	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0424	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-303-869-4664				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	Chief Financial Officer	CFO	Ms.	Gutierrez	Barbara		1-303-869-4664				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-720-789-6054				1-303-996-1600	epeak@myinnovage.com	750 E 6th St		Richmond	VA	23224	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	Customer Service Operations Contact	Regional Director of Quality	Mr.	Harrington	Paige		1-303-859-2096				1-303-996-1600	pharrington@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	Government Relations Contact	Senior Vice President, Government	Ms.	Dahan	Beverley		1-303-869-4664				1-303-996-1600	bdahan@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	Medicare Compliance Officer	VP of Pharmacy	Ms.	Chase	Darla		1-720-974-6785				1-303-996-1614	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	Part D Exceptions Contact	VP of Pharmacy	Ms.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending	1-720-974-6785				PACE - Nat		C	Atlanta
H0424	Pharmacy Network Management Contact	VP of Pharmacy	Ms.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0424	Pharmacy Technical Help Desk Contact	VP of Pharmacy	Ms.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending	1-720-974-6785				PACE - Nat		C	Atlanta
H0424	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-720-974-6031				1-303-996-1600	AKizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	06/07/2021	2023	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H0432	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	03/31/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H0432	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0432	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H0432	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/14/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0439	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O'Donnell Street		Baltimore	MD	21224	01/07/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O'Donnell Street		Baltimore	MD	21224	08/07/2014	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Hospice Contact	Enrollment/Billing Manager	Ms	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	01/07/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H0439	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H0439	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	08/30/2021	2023	CIGNA HEALTHCARE OF GEORGIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0440	Automated TrOOP Balance Transfer Contact	Executive Director	Mr.	Pettry	Jason		1-727-289-0062					JasonPettry@EmpathHealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	Best Available Evidence Contact			Pettry	Jason		1-727-289-0062					JasonPettry@EmpathHealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	Chief Financial Officer	CFO	Ms.	Bouhamid	Saida		1-727-586-4432					SaidaBouhamid@EmpathHealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	10/18/2022	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	CMS Casework Communication Contact	Executive Director	Mr.	Pettry	Jason		1-727-289-0062					JasonPettry@EmpathHealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	Coordination of Benefits Contact	Executive Director	Mr.	Pettry	Jason		1-727-289-0062					JasonPettry@EmpathHealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	Customer Service Operations Contact	Executive Director	Mr.	Pettry	Jason		1-727-289-0062					JasonPettry@EmpathHealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	Government Relations Contact	Vice President	Ms.	Kaminsky	Jennifer		1-727-324-1840					jenniferkaminsky@EmpathHealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	Medicare Compliance Officer	Vice President-Compliance	Ms.	Mosby	Laura		1-727-586-4432					LauraMosby@EmpathHealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	Part D Exceptions Contact	Executive Director	Mr.	Pettry	Jason						1-727-324-1866	JasonPettry@EmpathHealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending	1-727-289-0062				PACE - Nat		C	Atlanta
H0440	Pharmacy Network Management Contact	Pharmacy Director		Rigali	Aaron		1-727-586-4432					AaronRigali@EmpathHealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0440	Pharmacy Technical Help Desk Contact			Rigali	Aaron							AaronRigali@EmpathHealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending	1-727-586-4432				PACE - Nat		C	Atlanta
H0440	Plan to Plan Reconciliation Contact	Executive Director	Mr.	Pettry	Jason		1-727-289-0062					JasonPettry@EmpathHealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/24/2020	2023	EMPATH LIFE, LLC	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Pending					PACE - Nat		C	Atlanta
H0473	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H0473	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H0473	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0477	Automated TrOOP Balance Transfer Contact			Moroz	Margarita	N	1-413-627-9772					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	Best Available Evidence Contact			Blanter	Margarita		1-617-605-0727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	Chief Financial Officer	Administrator	Mrs	Blanter	Margarita		1-617-605-0727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	CMS Casework Communication Contact			Blanter	Margarita		1-617-605-0727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	Coordination of Benefits Contact			Blanter	Margarita		1-617-605-0727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	Customer Service Operations Contact			Blanter	Margarita		1-617-605-0727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	Government Relations Contact			Blanter	Margarita		1-617-605-0727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	Medicare Compliance Officer		Ms	Bessarabova	Daniella		1-413-374-2416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	04/24/2021	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	Part D Exceptions Contact		Mr	Tannery	Bob							sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active	1-888-278-7770				PACE - Nat		C	Boston
H0477	Pharmacy Network Management Contact		Mr	Tannery	Bob		1-888-278-7000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0477	Pharmacy Technical Help Desk Contact		Mr	Tannery	Bob							sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active	1-888-278-7770				PACE - Nat		C	Boston
H0477	Plan to Plan Reconciliation Contact		Mr	Tannery	Bob		1-888-278-7000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2023	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	Boston
H0480	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/26/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/26/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	09/26/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/26/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	09/26/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	09/26/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	09/26/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0480	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/10/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Demo	MeridianComplete (Medicare-Medicaid Plan)	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0482	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/05/2020	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0482	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0482	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H0482	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Automated TrOOP Balance Transfer Contact	Senior Manager, Medicare Operations		Halley	Derek		1-818-228-6374					Derek.Halley@blueshieldca.com	6300 Canoga Ave,		Woodland Hills	CA	91367	12/30/2020	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Best Available Evidence Contact	Manager, Medicare Operations		Loreto	Alfonso		1-818-228-7005					Alfonso.Loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	12/30/2020	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Chief Financial Officer	Senior Director, Medicare Finance	Mr.	Ballou	Taylor		1-818-228-6697					Taylor.Ballou@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		1-818-228-2651					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Coordination of Benefits Contact	Manager, Medicare Operations		Loreto	Alfonso		1-818-228-7005					alfonso.loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	11/02/2017	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Customer Service Operations Contact	Operations Specialist, Consultant		Lopez	Cynthia		1-818-228-6251					Cynthia.Lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	12/30/2020	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Government Relations Contact			Mata	Marcos	R	1-818-331-6954					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	12/12/2022	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Hospice Contact	Senior Program Manager		Fields	Torrie		1-415-229-5839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	02/02/2018	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		1-818-451-0484					Richard.Robinson@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	12/21/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Part D Exceptions Contact	Director, Pharmacy Prior Authorization		March	Nancee							nancee.march@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	1-800-776-4466				HMO - Health Maintenance Organization		C	San Francisco
H0504	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		1-510-607-2901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0504	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	1-888-970-0933				HMO - Health Maintenance Organization		C	San Francisco
H0504	Plan to Plan Reconciliation Contact	Financial Analyst Consultant		Dahl	Chris		1-818-228-2575					BSCP2PRecon@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0523	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/09/2020	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/21/2022	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/21/2022	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/21/2022	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H0523	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2022	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0523	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H0523	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0524	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	1-562-367-0592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Chief Financial Officer	Vice President & Chief Financial Officer	Ms.	Shepler	Courtney	R	1-510-271-4644					courtney.r.shepler@kp.org	National Medicare Finance, 1 Kaiser Plaza, 13th Floor	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	05/17/2017	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	CMS Casework Communication Contact	Executive Director, Medicare Compliance		Brandi	Jamie		1-510-209-1877					jamie.l.brandi@kp.org	1 Kaiser Plaza, 12th Fl.		Oakland	CA	94612	08/17/2020	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Coordination of Benefits Contact	Senior Director		Chung	Clarence		1-562-390-9293				1-562-658-3866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Customer Service Operations Contact			Services	Member		1-800-443-0815					mscc@kp.org	1800 Harrison St., 23rd Floor		Oakland	CA	94612	03/28/2013	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	1-510-271-6835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	03/28/2013	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Piper	Kimberly	C	1-206-473-9504				1-206-877-0645	Kimberly.C.Piper@kp.org	PO Box 9813, Bldg RCB, Mail Stop RCB-C3W-08	1300 SW 27th St, Bldg RCB, Mail Stop RCB-C3W-08	Renton	WA	98057-9055	04/06/2022	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Part D Exceptions Contact	Executive Director, Medicare Compliance		Brandi	Jamie							jamie.l.brandi@kp.org	1 Kaiser Plaza, 12th Fl.		Oakland	CA	94612	08/17/2020	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-800-443-0815				HMO - Health Maintenance Organization		C	San Francisco
H0524	Pharmacy Network Management Contact	National Pharmacy Benefits, Project Manager II		Munoz	Vanessa		1-562-447-7739					Vanessa.L.Munoz@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	04/16/2019	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0524	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	11/02/2016	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-877-645-1282				HMO - Health Maintenance Organization		C	San Francisco
H0524	Plan to Plan Reconciliation Contact	Director, National Medicare & Medicaid Finance		Callender	Margaret		1-510-433-6709					margaret.callender@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	08/14/2017	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0542	Automated TrOOP Balance Transfer Contact	Director, Data Operations - PACE		Fajardo	Lucia		1-323-384-8394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2022	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	Best Available Evidence Contact	VP - PACE Program	Mrs.	Garg	Joyita		1-323-558-7750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	10/27/2021	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	Chief Financial Officer	Vice President and Chief Financial Officer	Mr.	Esparza	Jose		1-323-889-7320					jesparza@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/02/2017	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	CMS Casework Communication Contact	Director, Data Operations - PACE		Fajardo	Lucia		1-323-384-8394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2022	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	Coordination of Benefits Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	1-866-466-9722					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	Customer Service Operations Contact	VP - PACE Program	Mrs.	Garg	Joyita		1-323-558-7750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	10/27/2021	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	Government Relations Contact	VP - PACE Program	Mrs.	Garg	Joyita		1-323-558-7750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	10/27/2021	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	Medicare Compliance Officer	Vice President, Corporate Compliance	Mr.	Jackson	Jerry		1-323-889-7383				1-323-889-7803	jejackson@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	10/13/2020	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	Part D Exceptions Contact	VP, Strategic Account Management		Harrison	Terry	J						tharrisson@citizensrx.com	1144 Lake Street		Oak Park	IL	60301	08/13/2021	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active	1-312-809-6877				PACE - Nat		C	San Francisco
H0542	Pharmacy Network Management Contact	AVP, Pharmacy		Lloyd	Genevieve		1-323-558-7666					glloyd@altamed.org	2040 Camfield Avenue		Los Angeles	CA	90040	08/13/2021	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0542	Pharmacy Technical Help Desk Contact	Manager, Clinical Pharmacy - PACE	Dr.	Bravo	Juan						1-213-217-5397	Jbravo@altamed.org	2040 Camfield Avenue		Los Angeles	CA	90040	02/22/2022	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active	1-323-204-7202				PACE - Nat		C	San Francisco
H0542	Plan to Plan Reconciliation Contact	Director, Budgets & Planning	Mr.	Hamamoto	Jeffrey		1-323-889-7354				1-323-889-7398	jhamamoto@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/13/2019	2023	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active					PACE - Nat		C	San Francisco
H0543	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	03/31/2021	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H0543	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0543	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H0543	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/14/2019	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0544	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	01/18/2022	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	04/21/2021	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	01/18/2022	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H0544	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H0544	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	04/21/2021	2023	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0562	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0562	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0562	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H0562	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0571	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Manosca	Nova		1-858-790-5873					partdcat@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/11/2017	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Best Available Evidence Contact	Member Services Manager	Ms.	Soder	Sonya		1-628-228-3306				1-415-397-2129	Sonya.Soder@CCHPHEALTHPLAN.COM	445 Grant Ave. Suite 700		San Francisco	CA	94108	03/18/2020	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Chief Financial Officer	CFO	Mr.	Choi	Ken		1-628-228-3251					ken.choi@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	CMS Casework Communication Contact	Compliance Officer	Ms.	Eisenberg	Janet		1-628-228-3393	3393				janet.eisenberg@cchphealthplan.com	445 Grant Avenue Suite 700		San Francisco	CA	94108	09/30/2022	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Coordination of Benefits Contact	Eligbility and Enrollment Supervisor		Leung	Kenneth		1-628-228-3268					kenneth.leung@cchphealthplan.com	445 Grant Ave Suite 700		San Francisco	CA	94102	01/27/2018	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Customer Service Operations Contact	Member Services Manager	Ms.	Soder	Sonya		1-628-228-3306				1-415-397-2129	Sonya.Soder@CCHPHEALTHPLAN.COM	445 Grant Ave. Suite 700		San Francisco	CA	94108	03/18/2020	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Government Relations Contact	Compliance Officer		Eisenberg	Janet		1-628-228-3393					janet.eisenberg@cchphealthplan.com	445 Grant Avenue Suite 700		San Francisco	CA	94108	09/30/2022	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Hospice Contact	Chief Medical Officer		Reich	Craig		1-628-228-3273					craig.reich@cchphealthplan.com	445 Grant Ave Suite 700		San Francisco	CA	94102	01/18/2022	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Medicare Compliance Officer	Compliance Officer	Ms.	Eisenberg	Janet		1-628-228-3393					janet.eisenberg@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	09/30/2022	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Part D Exceptions Contact	Dir PA Clinical Programs		McGurran	Shawn							shawn.mcgurran@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/11/2017	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active	1-858-790-6682				HMO - Health Maintenance Organization		C	San Francisco
H0571	Pharmacy Network Management Contact	Manager, PNS & Claims Operations		Burke	Sharon		1-858-790-7148					sharon.burke@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/11/2017	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0571	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/02/2020	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active	1-844-863-0357				HMO - Health Maintenance Organization		C	San Francisco
H0571	Plan to Plan Reconciliation Contact	CFO	Mr.	Choi	Ken		1-628-228-3251					Ken.Choi@cchphealthplan.com	445 Grant Avenue, suite 700	Suite 700	San Francisco	CA	94108	12/01/2021	2023	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	03/31/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H0609	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0609	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/14/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H0609	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/14/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0613	Automated TrOOP Balance Transfer Contact	Director, PACE Finance		Hewitt	Jessica		1-720-974-6767				1-303-996-1600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/31/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-720-789-6171				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/31/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	Chief Financial Officer	CFO	Mrs.	Gutierrez	Barbara		1-720-974-2434				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/31/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-804-543-0876				1-303-996-1600	epeak@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	10/01/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/31/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	Customer Service Operations Contact	Regional VP Operations COO	Mr.	Lohr	Clint		1-720-982-9868				1-303-996-1600	clohr@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/10/2022	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	Government Relations Contact	Executive VP Government Relations		Steckel	Carol		1-720-789-6157				1-303-996-1600	CSteckel@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/26/2022	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	Medicare Compliance Officer	VP of Pharmacy Services	Mrs.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/24/2020	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	Part D Exceptions Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/22/2020	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Denver
H0613	Pharmacy Network Management Contact	VP of Pharmacy Services	Mrs.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/22/2020	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0613	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/22/2020	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Denver
H0613	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-720-789-6171				1-720-917-3390	AKizewsk@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	08/31/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H0624	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/07/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H0624	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0624	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H0624	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/15/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0628	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/06/2018	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/06/2019	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/13/2020	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/22/2022	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/22/2022	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/22/2022	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H0628	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/30/2022	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0628	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H0628	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0630	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	1-562-367-0592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Chief Financial Officer	Vice President & Chief Financial Officer	Ms.	Shepler	Courtney	R	1-510-271-4644					courtney.r.shepler@kp.org	National Medicare Finance, 1 Kaiser Plaza, 13th Floor	c/o Kaiser Foundation Health Plan,	Oakland	CA	94612	05/17/2017	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	CMS Casework Communication Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	1-720-527-9215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Coordination of Benefits Contact	Senior Director		Chung	Clarence		1-562-390-9293				1-562-658-3866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Customer Service Operations Contact	Ex Director, Member Services Contact Centers, Denv		Martin	Norman	K	1-303-912-4673					NK.Martin@kp.org	7901 East Lowry Blvd, Ste 150 and 400		Denver	CO	80230	01/21/2022	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	1-510-271-6835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	11/16/2017	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Medicare Compliance Officer	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	1-720-527-9215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Part D Exceptions Contact	RegAdmin-Pharmacy Benefits, Compliance, Prof Aff		Clark	Denese	A						denese.a.clark@kp.org	16601 E. Centretech Parkway		Aurora	CO	80011	01/21/2022	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-303-326-6717				HMO - Health Maintenance Organization		C	San Francisco
H0630	Pharmacy Network Management Contact	RegAdmin-Pharmacy Benefits, Compliance, Prof Aff		Clark	Denese	A	1-303-326-6717				1-303-739-3660	denese.a.clark@kp.org	16601 E. Centretech Parkway		Aurora	CO	80011	04/03/2014	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0630	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	11/02/2016	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-888-791-7255				HMO - Health Maintenance Organization		C	San Francisco
H0630	Plan to Plan Reconciliation Contact	Director, National Medicare & Medicaid Finance		Callender	Margaret		1-510-433-6709					margaret.callender@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	08/14/2017	2023	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0672	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Hospice Contact	Enrollment/Billing Manager	Ms	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H0672	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H0672	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0710	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	03/31/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H0710	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0710	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H0710	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/15/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0712	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0712	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0712	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H0712	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0724	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0724	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H0724	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0738	Automated TrOOP Balance Transfer Contact	Manager, Technical Delivery & Oversight	Mr.	Gajarajan	Nivi		1-267-825-8648					ngajarajan2@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		1-484-497-1171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Chief Financial Officer	Chief Financial Officer	Mr.	Burgoyne	Michael		1-215-937-8875					mburgoyne@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	100 Stevens Drive	Philadelphia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	CMS Casework Communication Contact	Medicare QA Contract Acct Mgr	Ms.	Fine	Nicole		1-484-496-7479					nfine@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	10/17/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Coordination of Benefits Contact	Manager, Provider Network Oversight	Ms.	Williams	Kathy		1-843-746-7499					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/09/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		1-267-298-1794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	07/29/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Government Relations Contact	VP, Government Relations		Cozzo	Mr.Steven		1-215-937-8236					scozzo@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Hospice Contact	Director of Pharmacy, Medicare	Ms.	Shepard	Jen		1-215-937-8685					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Solomon	Mary		1-267-300-4846					mlsolomon@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	100 Stevens Drive, 2flr.	Philadelphia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						1-215-863-5100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-215-863-6483				HMO - Health Maintenance Organization		C	Philadelphia
H0738	Pharmacy Network Management Contact	Manager, Pharmacy Network Operations	Mr.	King	James		1-843-569-4845					jking@performrx.com	PerformRx	200 Stevens Dr.	Philadelphia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0738	Pharmacy Technical Help Desk Contact	Director, Service Operations	Ms.	Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/07/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-855-327-0511				HMO - Health Maintenance Organization		C	Philadelphia
H0738	Plan to Plan Reconciliation Contact	Director, Medicare Performance Management	Mr.	Kindred	Amanda		1-248-404-5991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H0755	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	03/31/2021	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H0755	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0755	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H0755	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/15/2019	2023	OXFORD HEALTH PLANS (CT), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0764	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H0764	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0764	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H0764	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H0783	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H0783	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H0783	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Automated TrOOP Balance Transfer Contact			Bean	Danielle		1-952-992-2864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Best Available Evidence Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Chief Financial Officer		Ms	Quist	Mary		1-952-992-2058					mary.quist@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	CMS Casework Communication Contact			Sikorski	TJ		1-952-992-8542				1-952-992-8492	thomas.sikorski@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/04/2023	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Coordination of Benefits Contact			Vilendrer	Krista		1-952-992-3252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Customer Service Operations Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Government Relations Contact			Kinsella	Ann		1-952-992-3832					ann.kinsella@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/21/2021	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Hospice Contact			Bourdages	Kathy		1-952-992-3653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/15/2019	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Medicare Compliance Officer		Mrs	Koranteng	Milly		1-952-992-2090					mildred.koranteng@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/22/2020	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/15/2019	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-952-992-2353				HMO - Health Maintenance Organization		C	Kansas City
H0798	Pharmacy Network Management Contact			Dornbrook-Lavender	Kimberly		1-952-992-3448					kimberly.dornbrook-lavender@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0798	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	La Tasha							LaTasha_Monroe@expressscripts.com	13051 N. Telecom Pkwy		Temple Terrace	FL	33637	11/17/2021	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Kansas City
H0798	Plan to Plan Reconciliation Contact			Cameron	Andrew		1-952-992-2386					Andrew.Cameron@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	11/12/2021	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0809	Automated TrOOP Balance Transfer Contact	Financial Coordinator	Ms	Selinger	Rae		1-413-748-7223				1-413-493-2024	rae.selinger@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	02/27/2019	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	Best Available Evidence Contact	Executive Director	Mr	Cheo	Emmanuel		1-406-647-2980				1-413-493-2024	Emmanuel.Cheo@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	03/30/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	Chief Financial Officer	Executive Director	Mr	Cheo	Emmanuel		1-413-827-4243				1-413-493-2024	Emmanuel.Cheo@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	10/03/2022	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	CMS Casework Communication Contact	Executive Director	Mr	Cheo	Emmanuel		1-413-827-4243				1-413-493-2024	Emmanuel.Cheo@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	03/30/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	Coordination of Benefits Contact	Finance Services Coordinator	Ms	Selinger	Rae		1-413-748-7223				1-413-493-2024	rae.selinger@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	05/13/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	Customer Service Operations Contact	Executive Director	Mr	Cheo	Emmanuel		1-413-827-4243				1-413-493-2024	Emmanuel.Cheo@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	03/30/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	Government Relations Contact	Executive Director	Mr	Cheo	Emmanuel		1-413-827-4243				1-413-493-2024	Emmanuel.Cheo@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	03/30/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/22/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	Part D Exceptions Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	12/31/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Boston
H0809	Pharmacy Network Management Contact	Executive Director	Mr	Cheo	Emmanuel		1-413-827-4243				1-413-493-2024	Emmanuel.Cheo@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	03/30/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0809	Pharmacy Technical Help Desk Contact	Executive Director	Mr	Cheo	Emmanuel						1-413-827-4243	emmanuel.cheo@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	02/19/2021	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	1-413-748-7223				PACE - Nat		C	Boston
H0809	Plan to Plan Reconciliation Contact	Financial Services Coordinator	Ms	Selinger	Rae		1-413-748-7223				1-413-493-2024	rae.selinger@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	05/13/2020	2023	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Boston
H0819	Automated TrOOP Balance Transfer Contact	None		Dodson	David		1-814-535-6000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Best Available Evidence Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Chief Financial Officer	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	CMS Casework Communication Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Coordination of Benefits Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Customer Service Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Government Relations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Medicare Compliance Officer	Executive Director	Mr	Hantz	Jordan		1-717-757-5433					SLYDirectors@seniorlifeyork.com	1500 Memory Lane Extended		York	PA	17402	08/12/2019	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Part D Exceptions Contact	Chief Financial Officer	Mr	Dodson	David						1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active	1-814-535-6000	22102			PACE - Nat		C	Philadelphia
H0819	Pharmacy Network Management Contact			Rowland	Bob		1-724-275-1203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Pharmacy Technical Help Desk Contact			Rowland	Bob							Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active	1-724-275-1203	219			PACE - Nat		C	Philadelphia
H0819	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0826	Automated TrOOP Balance Transfer Contact			Meronk	Cheryl		1-949-439-6130					cmeronk@innovativeih.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	06/09/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Best Available Evidence Contact			Heredia	Beatriz		1-559-519-4472					bheredia@iihcplans.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	12/29/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Chief Financial Officer		Mr.	Longoria	Daniel		1-510-507-2010					dlongoria@innovativeih.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	02/09/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	CMS Casework Communication Contact			Heredia	Beatriz		1-559-519-4472					bheredia@iihcplans.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	12/29/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Coordination of Benefits Contact			Malott	Tim		1-714-504-3729					tmalott@iihcplans.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	04/07/2022	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Customer Service Operations Contact			Meronk	Cheryl		1-949-439-6130					cmeronk@innovativeih.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	02/09/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Government Relations Contact	Compliance Officer	Mr.	Roth	Clifford		1-559-412-0284					croth@iihcplans.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	12/29/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Hospice Contact			Rigden	Denise		1-559-388-5221					drigden@iihcplans.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	12/29/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Medicare Compliance Officer		Mr.	Roth	Clifford		1-559-772-4072					croth@iihcplans.com	1200 Newport Center Dr. Suite 230		Newport Beach	CA	92660	10/19/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Part D Exceptions Contact			Champ	Nicole							nchamp@iihcplans.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	12/30/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active	1-888-900-6807				HMO - Health Maintenance Organization		C	San Francisco
H0826	Pharmacy Network Management Contact	Clinical Pharmacy Manager		Hofer	Alissa		1-715-852-2096					ahofer@pharmastar.com	P.O. Box 1123		Eau Claire	WI	54720	12/30/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0826	Pharmacy Technical Help Desk Contact	Clinical Pharmacy Manager		Hofer	Alissa							ahofer@pharmastar.com	P.O. Box 1123		Eau Claire	WI	54720	12/30/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active	1-800-942-2931				HMO - Health Maintenance Organization		C	San Francisco
H0826	Plan to Plan Reconciliation Contact			Malott	Tim		1-714-504-3729					tmalott@iihcplans.com	1200 Newport Center Dr.	Suite 230	Newport Beach	CA	92660	12/30/2021	2023	INNOVATIVE INTEGRATED HEALTH COMMUNITY PLANS, INC.	Local CCP	Integrated HealthPlan	HMO/HMOPOS		Innovative Integrated Health, Inc.	710	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0838	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Farb	Mike		1-612-400-3275					mfarb@brighthealthcare.com	8000 Norman Center Drive		Bloomington	MN	55437	12/15/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Best Available Evidence Contact			Brown	Elena		1-210-219-0766					ebrown@brighthealthcare.com	8000 Norman Center Drive		Bloomington	MN	55437	11/14/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Chief Financial Officer	Chief Financial Officer	Mr.	Uma	Chet		1-626-373-6811					cuma@brighthealthgroup.com	5455 Garden Grove	Suite 500	Westminster	CA	92683	10/28/2021	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	CMS Casework Communication Contact	Director, Compliance	Ms.	Olney	Marcy		1-720-839-1910					molney@brighthealthgroup.com	8000 Norman Street	Suite 150	Bloomington	MN	55425	11/14/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Coordination of Benefits Contact			Farb	Mike		1-612-238-1321					mfarb@brighthealthcare.com	8000 Norman Center Drive		Minneapolis	MN	55437	11/14/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Customer Service Operations Contact	Director, Compliance	Ms.	Olney	Marcy		1-720-839-1910					molney@brighthealthgroup.com	8000 Norman Street	Suite 150	Bloomington	MN	55425	11/14/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Government Relations Contact			MCCabe	Denise		1-612-384-6581					dmccabe@brighthealthgroup.com	8000 Norman Center Drive		Bloomington	MN	55437	11/14/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Hospice Contact	Director, Pharmacy Operations		Farb	Mike		1-612-400-3275					mfarb@brighthealthcare.com	8000 Norman Center Drive		Bloomington	MN	55437	12/15/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Medicare Compliance Officer	Senior Compliance Counsel	Mrs.	Shieh	Annie		1-626-388-2390	2885			1-626-388-2367	ahsu@centralhealthplan.com	1540 Bridgegate Drive		Diamond Bar	CA	91765	11/14/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer PKWY		Dublin	OH	43017	12/15/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	Chicago
H0838	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/15/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0838	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N Telecom PKWY	STE 150	Temple Terrace	FL	33637	12/15/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active	1-877-728-0177				HMO - Health Maintenance Organization		C	Chicago
H0838	Plan to Plan Reconciliation Contact	RVP Finance	Mr.	Uma	Chet		1-626-373-6811					cuma@brighthealthgroup.com	5455 Garden Grove Blvd	Suite 500, Attn:  Finance Department/ P2P	Westminster	CA	92683	02/14/2022	2023	UNIVERSAL CARE, INC.	Local CCP	Brand New Day	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0839	Automated TrOOP Balance Transfer Contact	Finance Manager		Raynor	Eddy		1-919-425-3053					eraynor@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	07/30/2019	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	Best Available Evidence Contact	Executive Director	Ms	Hively	Antionette		1-919-425-2971					thively@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	09/27/2019	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	Chief Financial Officer	VP of Financial Services	Ms	Gavin	Nancy		1-612-428-7840				1-952-941-0428	ngavin@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	CMS Casework Communication Contact	Executive Director	Ms	Hively	Antionette		1-919-425-2971					thively@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	09/27/2019	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	Coordination of Benefits Contact	Finance Manager		Raynor	Eddy		1-919-425-3053					eraynor@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	07/30/2019	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	Customer Service Operations Contact	Executive Director	Ms	Hively	Antionette		1-919-425-2971					thively@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	09/27/2019	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	Government Relations Contact	Executive Director	Ms	Hively	Antionette		1-919-425-2971					thively@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	09/27/2019	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	Medicare Compliance Officer	Director of Program Integrity/Compliance	Ms	Linnell	Kathryn	R	1-970-964-3500				1-866-829-9949	klinnell@voa.org	2377 Robins Way		Montrose	CO	81401	02/24/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	Part D Exceptions Contact	Finance Manager	Mr	Raynor	Eddy						1-919-425-3001	eraynor@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	07/30/2019	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active	1-919-425-3000				PACE - Nat		C	Atlanta
H0839	Pharmacy Network Management Contact	Medical Director		Bugaj	Gregory		1-919-425-3000					gbugaj@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	12/05/2017	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0839	Pharmacy Technical Help Desk Contact	Medical Director		Bugaj	Gregory							gbugaj@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	12/05/2017	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active	1-800-425-3000				PACE - Nat		C	Atlanta
H0839	Plan to Plan Reconciliation Contact	Finance Manager	Mr	Raynor	Eddy		1-919-425-3053				1-919-425-3001	eraynor@voa.org	4022 Stirrup Creek Drive Suite 315		Durham	NC	27703	07/30/2019	2023	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	National PACE	Senior CommUnity Care of North Carolina	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H0870	Automated TrOOP Balance Transfer Contact	CFO		Ringer	Cheryl		1-540-313-9200					cringer@blueridgehospice.org	314 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	Best Available Evidence Contact	Executive Director		Myers	SueAnn		1-540-313-9200					samyers@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	Chief Financial Officer	CFO	Ms	Cheryl	Ringer		1-540-313-9200					cringer@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	CMS Casework Communication Contact	Executive Director		Myers	SueAnn		1-540-313-9200					samyers@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	Coordination of Benefits Contact	Executive Director		Myers	SueAnn		1-540-313-9200					samyers@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	Customer Service Operations Contact	Executive Director		Myers	SueAnn		1-540-313-9200					samyers@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	Government Relations Contact	CFO		Ringer	Cheryl		1-540-313-9200					cringer@blueridgehospice.org	314 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	Medicare Compliance Officer	CEO	Ms	Fried	Cheryl	H	1-540-313-9200					chamiltonfried@blueridgehopsice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	Part D Exceptions Contact	Quality and Compliance Director		Dehaven	Angel						1-540-678-0584	adehaven@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending	1-800-238-5678				PACE - Nat		C	Philadelphia
H0870	Pharmacy Network Management Contact	Quality and Compliance Director		Dehaven	Angel		1-540-313-9200					adehaven@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0870	Pharmacy Technical Help Desk Contact	Quality and Compliance Director		Dehaven	Angel						1-540-678-0584	adehaven@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending	1-800-238-5678				PACE - Nat		C	Philadelphia
H0870	Plan to Plan Reconciliation Contact	CFO	Ms	Cheryl	Ringer		1-540-313-9200					cringer@blueridgehospice.org	814 Hope Drive		Winchester	VA	22601	09/29/2022	2023	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0876	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment and Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Best Available Evidence Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931				randrade@commonwealthcare.org	30 Winter St		Boston	MA	02108	02/05/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Chief Financial Officer	Chief Financial Officer	Ms.	Hamilton	Mary		1-857-327-1953					mahamilton@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	CMS Casework Communication Contact	Director, Appeals& Grievances		Schenk	Tyrone		1-857-327-3320					tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Coordination of Benefits Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931			1-617-426-3109	randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/05/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Customer Service Operations Contact	VP, Customer Service		Habib	Fred		1-617-426-0600	1504			1-617-426-3097	fhabib@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/21/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Government Relations Contact	VP, Government Relations		Preede	Ken		1-617-426-0600	51412				kpreede@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/30/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Hospice Contact	Palliative Care Medical Director		Ragland	Julia		1-781-525-4203					JRagland@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	10/04/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	Lavallee	Katherine		1-617-947-5780					KLavalee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/01/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Part D Exceptions Contact	Sr. Manager, Clinical Prior Auth		LeClair	Christophe						1-920-221-4676	Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/25/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877				HMO - Health Maintenance Organization		C	Boston
H0876	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@Navitus.com	361 Integrity Drive		Madison	WI	53713	03/25/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0876	Pharmacy Technical Help Desk Contact	Sr. Mgr, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	53713	03/25/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Boston
H0876	Plan to Plan Reconciliation Contact	Accounts Receivable Coordinator		Newman	Elaine		1-617-426-0600	52580				enewman@commonwealthcare.org	30 Winter St		Boston	MA	02108	08/25/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0885	Automated TrOOP Balance Transfer Contact	Manager, PBM Ops.	Ms.	Hanson	Michelle		1-612-777-6755					EOBP2P@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	10/06/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Best Available Evidence Contact	Supervisor, Govt. Programs		Achoe	Kisha		1-973-466-7328					BaeInquiries@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	01/22/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Chief Financial Officer	CFO	Mr.	Meaney	Frank		1-203-525-6777					Frank.Meaney@BravenHealth.com	3 Penn Plaza East		Newark	NJ	07105	01/03/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	CMS Casework Communication Contact	Director, GP Operations		Maramraju	Venkata		1-609-537-2113					venkata.maramraju@horizonblue.com	1700 American Boulevard		Pennington	NJ	08534	01/23/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Coordination of Benefits Contact	Manager, PBM Ops	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6705	COBMedD@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	10/06/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Customer Service Operations Contact	Director, Operations - GP		Yanek	John		1-518-220-8000					john_yanek@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	06/13/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Government Relations Contact	Medicare Compliance Officer	Ms.	Keehn	Lisa		1-646-221-4210					lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	04/30/2021	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Hospice Contact	Manager, Clinical Pharmacy		Sun	Jane		1-973-466-5044					Jane_Sun@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	01/23/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Keehn	Lisa		1-646-221-4210					lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	04/14/2021	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Part D Exceptions Contact	Director, Reg/Audit Response	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd		Eagan,	MN	55121	04/15/2021	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active	1-800-693-6651				PPO - BBA		C	New York
H0885	Pharmacy Network Management Contact	AVP, Network Mgmt	Ms	Conlin	Marci		1-612-777-2842					Marci.Conlin@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	04/15/2021	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0885	Pharmacy Technical Help Desk Contact	Director, Member Services		Shultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	12/30/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active	1-800-391-1926				PPO - BBA		C	New York
H0885	Plan to Plan Reconciliation Contact	Pharmacy Business Admin		Cunningham	Theresa		1-973-466-7886				1-973-466-4665	theresa_cunningham@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	01/23/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		NJ Collaborative Care, LLC	755	Yes	Active					PPO - BBA		C	New York
H0907	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	01/27/2022	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H0907	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H0907	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	AMERIGROUP IOWA, INC.	Local CCP	Amerigroup Iowa	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0908	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Government Relations Contact	Vice President, Complex Care Products	Ms.	Arden	Gale		1-314-725-4477	47759				garden@centene.com	7700 Forsyth Blvd		St. Louis	MO	63105	08/09/2017	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0908	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0908	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H0908	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H0913	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0913	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H0913	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0927	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2022	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-888-840-3068				Demo Risk Option C	MMP HMO Demo	C	Chicago
H0927	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	HEALTH CARE SERVICE CORPORATION	Demo	Blue Cross Community MMAI	Medicare-Medicaid Plan HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H0934	Automated TrOOP Balance Transfer Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Best Available Evidence Contact			Hall	Kristi		1-650-336-0300					kristi.hall@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	06/10/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Chief Financial Officer		Mr.	Epstein	Ethan		1-203-695-1178					ethan.epstein@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	CMS Casework Communication Contact			Goel	Jyotika		1-619-746-2459					jyotika.goel@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Coordination of Benefits Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Customer Service Operations Contact			Thiry	Matt		1-650-430-5157					matt.thiry@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	05/19/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Government Relations Contact			Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Medicare Compliance Officer		Ms.	Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part D Exceptions Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	1-800-734-8041				PACE - Nat		C	San Francisco
H0934	Pharmacy Network Management Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Pharmacy Technical Help Desk Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	1-800-734-8041				PACE - Nat		C	San Francisco
H0934	Plan to Plan Reconciliation Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0969	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H0969	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0969	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H0969	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H0978	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations and Formulary		Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/01/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Best Available Evidence Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		1-562-637-1234				1-562-989-5243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Chief Financial Officer	Controller	Ms.	Havai	Virginia		1-562-989-8300					vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	CMS Casework Communication Contact	Director, Reg Audit & Ent Mntrng		Cordova	Elizabeth		1-562-997-3131				1-562-989-5120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/16/2022	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Coordination of Benefits Contact	Director, Pharmacy Operations and Formulary	Ms.	Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/03/2022	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		1-562-997-1805				1-562-989-5181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Government Relations Contact	Sr. Vice President, Public & Government Affairs	Ms.	Morrell	Adrienne		1-202-349-9008				1-562-989-9439	amorrell@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Hospice Contact	Manager, Pharmacy Experience and Access	Mr.	Tran	Tri		1-562-308-2884				1-562-997-3196	TMTran@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	02/09/2022	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Medicare Compliance Officer	Compliance Officer	Ms.	Hawkins	Ginette		1-562-308-1195					GHawkins@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Part D Exceptions Contact	Senior Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/01/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	San Francisco
H0978	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/19/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0978	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy	STE 150	Temple Terrace	FL	33637	12/01/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	San Francisco
H0978	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		1-562-989-8300				1-562-989-0101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H0982	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibity		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	01/31/2019	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Best Available Evidence Contact	Director of Operations		Megias	Lisette		1-305-913-0049					lmegias@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	04/29/2021	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Chief Financial Officer	Chief Financial Officer	Mr.	De Cardenas	Juan		1-305-913-0055					jdecardenas@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/13/2018	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	CMS Casework Communication Contact	VP of Compliance		Biehler	Marie		1-305-420-3036					mbiehler@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	04/29/2021	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Coordination of Benefits Contact	Director of Operations		Megias	Lisette		1-305-510-8344					lmegias@solishealthplans.com	9250 NW 36th Street	# 400	Miami	FL	33178	07/26/2021	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Customer Service Operations Contact	Manager of Service Operations	Ms.	Roman	Vanessa		1-844-447-6547					vroman@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	03/03/2022	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Government Relations Contact	VP of Compliance	Mrs.	Biehler	Marie		1-954-774-7088					mbiehler@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	11/03/2021	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Hospice Contact	Medical Director	Dr.	Armas	Jose		1-305-420-3056					jarmas@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	11/03/2021	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Medicare Compliance Officer	VP of Compliance	Mrs.	Biehler	Marie		1-305-420-3036					mbiehler@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	04/29/2021	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Part D Exceptions Contact	Manager, Medicare Clinical Programs	Ms.	Murphy	Eileen						1-608-729-2525	Eileen.Murphy@Navitus.com	1025 West navitus Drive		Appleton	WI	54913	03/10/2020	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active	1-608-729-1525				HMO - Health Maintenance Organization		C	Atlanta
H0982	Pharmacy Network Management Contact	Associate Director, Provider Operations	Mr.	Burdick	Tammy		1-920-221-4089				1-920-221-4589	tammy.burdick@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/10/2020	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0982	Pharmacy Technical Help Desk Contact	Pharmacy Technical Help Desk Contact	Sr.	Nett	Danielle						1-920-221-4724	Danielle.nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/03/2020	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Atlanta
H0982	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	De Cardenas	Juan		1-305-913-0055					jdecardenas@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	06/13/2019	2023	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1016	Automated TrOOP Balance Transfer Contact	Director, Clinical Pharmacy Management		Lachuk	Lester		1-305-671-0066				1-352-337-8737	Lester.Lachuk@AvMed.org	4300 NW 89 Blvd.		Gainesville	FL	32606	07/06/2022	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Best Available Evidence Contact	Supervisor, Medicare Enrollment		Villar	Adna		1-305-671-5437	26130			1-305-671-0087	Adna.Villar@AvMed.org	9400 S Dadeland Blvd.		Miami	FL	33156	02/22/2022	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Chief Financial Officer	Senior Vice President and Chief Financial Officer	Mr.	Bowling	Philip		1-305-671-7346					Philip.Bowling@AvMed.org	9400 S. Dadeland Blvd.		Miami	FL	33156	03/21/2022	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	CMS Casework Communication Contact	Director, Corporate Compliance		Lojko	Catherine		1-352-372-8400	40740				Catherine.Lojko@AvMed.org	4300 NW 89 Blvd.		Gainesville	FL	32606	11/22/2021	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Coordination of Benefits Contact	Supervisor, Medicare Enrollment		Villar	Adna		1-305-671-5437	26130			1-305-671-0087	Adna.Villar@AvMed.org	9400 S Dadeland Blvd.		Miami	FL	33156	02/22/2022	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Customer Service Operations Contact	Director, Member Engagement		Hernandez	Juan		1-305-671-7354					Juan.Hernandez@AvMed.org	9400 S. Dadeland Blvd.		Miami	FL	33156	03/02/2022	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Government Relations Contact	Director, Public Policy and Benefit Contracts		Crews	Jacqueline	M	1-352-337-8832	40832				Jackie.Crews@AvMed.org	4300 NW 89 Blvd.		Gainesville	FL	32606	03/02/2022	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Hospice Contact	Director, Clinical Pharmacy Management		Lachuk	Lester		1-305-671-0066				1-352-337-8737	Lester.Lachuk@AvMed.org	4300 NW 89 Blvd.		Gainesville	FL	32606	07/06/2022	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Medicare Compliance Officer	Vice President, Assurance and Compliance	Ms.	Rice	Tammy		1-352-337-8747				1-352-337-8551	Medicare.Compliance@AvMed.org	4300 NW 89 Blvd.		Gainesville	FL	32606	11/22/2021	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Part D Exceptions Contact	Director, Clinical Pharmacy Management		Lachuk	Lester						1-352-337-8737	Lester.Lachuk@AvMed.org	4300 NW 89 Blvd.		Gainesville	FL	32606	07/06/2022	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active	1-800-237-1255				HMO - Health Maintenance Organization		C	Philadelphia
H1016	Pharmacy Network Management Contact	Advisor		Loveland	Chet		1-480-606-4865					Chet.Loveland@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	12/06/2021	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1016	Pharmacy Technical Help Desk Contact	Pharmacy Help Desk Queue		Pharmacy Help Desk	Caremark							Chet.Loveland@CVSHealth.com	CVS Caremark Part D Services LLC, Medicare Operations	9501 E. Shea Blvd., MC042	Scottsdale	AZ	85260	12/06/2021	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Philadelphia
H1016	Plan to Plan Reconciliation Contact	Senior Staff Accountant		Brown	Patricia		1-352-372-8400	40984			1-352-337-8897	Patricia.Brown@AvMed.org	4300 NW 89th Blvd.		Gainesville	FL	32606	11/22/2021	2023	AVMED, INC.	Local CCP	AvMed Medicare	HMO/HMOPOS		AvMed, Inc.	20	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1019	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Best Available Evidence Contact	Associate VP	Mrs.	Dicus	Natalie		1-813-439-5017				1-813-560-1398	natalie.dicus@humana.com	4925 Independence Pkwy	Suite # 300	Tampa	FL	33634	03/04/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	CMS Casework Communication Contact	Grievance and Appeals Director	Mrs.	Machado	Elina		1-954-329-5278				1-800-956-4288	elina.machado@careplus-hp.com	6101 Blue Lagoon Drive	Suite #195	Miami	FL	33126	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Customer Service Operations Contact	Director, CarePlus Member Services	Mrs.	Ford	Angela		1-502-994-2678				1-502-508-6297	aford@humana.com	500 West Main Street	Floor 22	Louisville	KY	40204	04/13/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H1019	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1019	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H1019	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1032	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H1032	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1032	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H1032	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Automated TrOOP Balance Transfer Contact	Manager, PBM operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/27/2020	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Best Available Evidence Contact	Sr. Director EMB		Chick	Benjamin		1-904-905-1711					benjamin.chick@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	07/16/2019	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Chief Financial Officer	SVP and CFO	Mr.	Justice	Thurman		1-904-905-5085					Thurman.Justice@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 8th Floor	Jacksonville	FL	32246	02/17/2020	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	CMS Casework Communication Contact	Sr Manager Business Support		Stewart	Delores		1-904-905-0558					Delores.Stewart@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	07/17/2020	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Coordination of Benefits Contact	Manager PBM Operations		Hanson	Michelle		1-612-777-6755				1-312-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	02/16/2021	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Customer Service Operations Contact	Sr Director Member Contact		Gamble	LaTonya		1-904-905-2057					latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Government Relations Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		1-904-445-8502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Hospice Contact	Medical Clinical Pharmacist Pharmacy Govt Prog		Adams	Tangela		1-904-905-0002					tangela.adams@floridablue.com	4800 Deerwood Campus Pkwy	DCC 900, 4th Floor	Jacksonville	FL	32246	01/24/2022	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Medicare Compliance Officer	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		1-904-445-8502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Part D Exceptions Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	1-800-477-3736	56307			HMO - Health Maintenance Organization		C	Atlanta
H1035	Pharmacy Network Management Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		1-904-905-6307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1035	Pharmacy Technical Help Desk Contact			HelpDesk	Prime Part	D					1-888-245-2422	pharmacyops@primetherapeutics.com	Prime Therapeutics, LLC	1305 Corporate Center Drive	Eagan	MN	55121	12/18/2018	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	1-888-877-6420				HMO - Health Maintenance Organization		C	Atlanta
H1035	Plan to Plan Reconciliation Contact	Accounting Specialist		Williams	Lynn		1-904-905-4568					lynn.williams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	01/04/2019	2023	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1036	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H1036	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H1036	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1043	Automated TrOOP Balance Transfer Contact	Sr. Claims Adjudicator	Ms	Johnson	Julie		1-305-751-8626	68204			1-305-762-1431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	11/11/2022	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	Best Available Evidence Contact	EVP-PACE & President, Florida PACE Centers	Mr.	Hess	Steve		1-305-751-8626	66799			1-305-762-1431	SHess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	02/09/2022	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	Chief Financial Officer	Chief Financial Officer	Mr.	Durr	Michael		1-305-751-8626	63298				MDurr@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	01/04/2023	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	CMS Casework Communication Contact	AVP of PACE	Ms.	Lane	Maria		1-305-751-8626	66703			1-305-795-1855	mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	11/11/2022	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	Coordination of Benefits Contact	AVP of PACE	Ms.	Lane	Maria		1-305-751-8626	66703			1-305-762-1538	mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	11/11/2022	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	Customer Service Operations Contact	EVP-PACE & President, Florida PACE Centers	Mr.	Hess	Steve		1-305-751-8626	66799			1-305-762-1538	SHess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	02/09/2022	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	Government Relations Contact	AVP of PACE	Ms.	Lane	Maria		1-305-751-8626	66703			1-305-762-1488	MLane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	01/04/2023	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	Medicare Compliance Officer	AVP of PACE	Ms.	Lane	Maria		1-305-751-8626	66703			1-305-795-1855	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	01/04/2023	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	Part D Exceptions Contact	AVP of PACE	Ms.	Lane	Maria							Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	11/11/2022	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active	1-305-751-8626	66703			PACE - Nat		C	Atlanta
H1043	Pharmacy Network Management Contact	Associate Vice President PACE Medical Director	Dr.	Alzugaray	Edilia		1-305-751-8626	66922				EAlzugaray@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	12/22/2020	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1043	Pharmacy Technical Help Desk Contact	Database Programer	Mr.	Steinberg	Israel							isteinberg@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	01/04/2023	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active	1-305-751-8626	65405			PACE - Nat		C	Atlanta
H1043	Plan to Plan Reconciliation Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		1-305-751-8626	68204			1-305-762-1431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	01/04/2023	2023	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active					PACE - Nat		C	Atlanta
H1045	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H1045	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1045	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/15/2019	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H1045	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/15/2019	2023	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1099	Automated TrOOP Balance Transfer Contact	Medicare Integrity Analyst		Gutierrez	Dalia		1-321-419-7769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Best Available Evidence Contact	Medicare Integrity Analyst		Gutierrez	Dalia		1-321-419-7769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Chief Financial Officer	Chief Financial Officer	Mr.	Pulver	Joshua		1-315-289-5913					Joshua.Pulver@HF.org	6450 US Highway 1		Rockledge	FL	32955-5747	12/28/2022	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	CMS Casework Communication Contact	Director, Member/Provider Appeals & Grievances		Heinssen	Lori		1-321-434-6761					Lori.Heinssen@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/15/2021	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Coordination of Benefits Contact			Team	Pharmacy		1-800-716-7737					hfhppharmacy@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/13/2022	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Customer Service Operations Contact	Interim Director of Customer Service		Gerace	Brian		1-321-434-4478					Brian.Gerace@hf.org	6450 US Highway 1		Rockledge	FL	32955	10/08/2021	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Government Relations Contact	System V.P, Assoc. Gen. Counsel, Chief Privacy Off	Mr.	Norton	Timothy	D	1-321-434-1836					Timothy.Norton@HF.org	3300 Fiske Boulevard		Rockledge	FL	32955	12/17/2020	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Hospice Contact	System V.P, Assoc. Gen. Counsel, Chief Privacy Off	Mr.	Norton	Timothy	D	1-321-434-1836					Timothy.Norton@HF.org	3300 Fiske Boulevard		Rockledge	FL	32955	12/17/2020	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Norton	Timothy	D	1-717-870-7106					Timothy.Norton@HF.org	3300 Fiske Boulevard		Rockledge	FL	32955	01/07/2021	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Part D Exceptions Contact			Team	Pharmacy							hfhppharmacy@hf.org	6450 US Hwy #1		Rockledge	FL	32955	04/24/2020	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active	1-800-716-7737				HMO - Health Maintenance Organization		C	Atlanta
H1099	Pharmacy Network Management Contact	Director of Pharmaceutical Services		Terkoski	Eugene		1-321-434-5688					Eugene.Terkoski@HF.org	6450 US Highway 1		Rockledge	FL	32955	08/19/2021	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1099	Pharmacy Technical Help Desk Contact	Sr Managed Care Pharmacist		Terkoski	Eugene							molly.eickholt@hf.org	6450 US Highway 1		Rockledge	FL	32940	09/29/2022	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active	1-800-716-7737				HMO - Health Maintenance Organization		C	Atlanta
H1099	Plan to Plan Reconciliation Contact	System V.P, Assoc. Gen. Counsel, Chief Privacy Off	Mr.	Norton	Timothy	D	1-321-434-1836					Timothy.Norton@HF.org	3300 Fiske Boulevard		Rockledge	FL	32955	12/17/2020	2023	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/13/2020	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/22/2022	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/22/2022	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/22/2022	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H1109	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/30/2022	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1109	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H1109	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1111	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/23/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H1111	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1111	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H1111	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1112	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H1112	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1112	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H1112	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1119	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Pardue	Lyndsey		1-501-590-0180				1-866-870-3080	lpardue@accesshealth.services	One Riverfront Place, Suite 600		North Little Rock	AR	72114	03/08/2022	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Best Available Evidence Contact	Member Service Manager		Stacy	Brittany		1-501-255-0873				1-866-705-3652	bstacy@access-healthservices.com	One Riverfront Place, Suite 513A		North Little Rock	AR	72114	01/30/2018	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Chief Financial Officer	Chief Financial Officer	Mr.	Film	George		1-330-498-8203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	CMS Casework Communication Contact	Compliance Officer	Ms.	Ferrara	Donna		1-330-498-8220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/02/2020	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Coordination of Benefits Contact	Director of Part D Operations		Pardue	Lyndsey		1-501-590-0180				1-866-870-3080	lpardue@accesshealth.services	One Riverfront Place, Suite 600		North Little Rock	AR	72114	03/08/2022	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Customer Service Operations Contact			Campbell	Brad		1-501-400-4118				1-866-705-3692	bcampbell@access-healthservices.com	One Riverfront Place, Suite 525		North Little Rock	AR	72114	03/08/2022	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Government Relations Contact	Compliance Officer	Ms.	Ferrara	Donna		1-330-498-8220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/02/2020	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Hospice Contact	Director of Part D Operations		Pardue	Lyndsey		1-501-590-0180				1-866-870-3080	lpardue@accesshealth.services	One Riverfront Place, Suite 600		North Little Rock	AR	72114	03/08/2022	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Medicare Compliance Officer	Compliance Officer	Ms.	Ferrara	Donna		1-234-215-1042					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/13/2020	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Part D Exceptions Contact	Director of Part D Operations		Pardue	Lyndsey						1-866-870-3080	lpardue@accesshealth.services	One Riverfront Place, Suite 600		North Little Rock	AR	72114	03/08/2022	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active	1-501-590-0180				HMO - Health Maintenance Organization		C	Chicago
H1119	Pharmacy Network Management Contact	Director Pharmacy Network		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		N Canton	OH	44720	12/14/2022	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							tconn@elixirsolutions.com	7835 Freedom Avenue NW		N Canton	OH	44720	12/14/2022	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active	1-833-459-4423				HMO - Health Maintenance Organization		C	Chicago
H1119	Plan to Plan Reconciliation Contact	Controller	Mr.	Logan	Justin		1-330-498-8171				1-330-498-5295	Justin.Logan@TSGrinc.com	7171 Keck Park Circle NW		North Canton	OH	44720	12/14/2022	2023	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1121	Automated TrOOP Balance Transfer Contact	Regional Director of Operations	Mrs	Hulon	Amber		1-727-417-5819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	Best Available Evidence Contact	Executive Assistant		Anderson	Brooke		1-559-960-5671					BAnderson@kinshiphs.com	1099 Sylmar Ave Apt 203		Clovis	CA	93612	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	Chief Financial Officer	CEO	Mr	Enderle	John		1-860-655-9211					jenderle@kinshiphs.com	31 Andreis Trail		South Windsor	CT	06074	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	CMS Casework Communication Contact	Regional Director of Operations	Mrs	Hulon	Amber		1-727-417-5819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	Coordination of Benefits Contact	Regional Director of Operations	Mrs	Hulon	Amber		1-727-417-5819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	Customer Service Operations Contact	Director of Operations and Implementation	Mr.	Beijer	David		1-828-702-9191					dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	Government Relations Contact	Chief Strategy Officer	Ms.	Kohn	Judy		1-917-270-0599					jkohn@kinshiphs.com	260 Pearsall place		Lawrence	NY	11559	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	Medicare Compliance Officer	Senior Vice President	Mrs.	Melancon	Sharon		1-559-892-6640					smelancon@kinshiphs.com	300 Bessie Coleman Blvd		Waxahachie	TX	75165	12/29/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	Part D Exceptions Contact	Regional Director of Operations	Mrs	Hulon	Amber							ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending	1-727-417-5819				PACE - Nat		C	New York
H1121	Pharmacy Network Management Contact	Senior Vice President	Mrs.	Melancon	Sharon		1-559-892-6640					smelancon@kinshiphs.com	300 Bessie Coleman Blvd		Waxahachie	TX	75165	12/29/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1121	Pharmacy Technical Help Desk Contact	Director of Operations and Implementation	Mr.	Beijer	David						1-559-238-9224	dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending	1-800-639-1305				PACE - Nat		C	New York
H1121	Plan to Plan Reconciliation Contact	Executive Assistant		Anderson	Brooke		1-559-960-5671					BAnderson@kinshiphs.com	1099 Sylmar Ave Apt 203		Clovis	CA	93612	10/05/2022	2023	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H1170	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	1-562-367-0592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Chief Financial Officer	Vice President & Chief Financial Officer	Ms.	Shepler	Courtney	R	1-510-271-4644					courtney.r.shepler@kp.org	National Medicare Finance, 1 Kaiser Plaza, 13th Floor	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	05/17/2017	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	CMS Casework Communication Contact	Mrg, Member Relations		Kirkwood-Murphy	Alison	X	1-510-219-5415					alison.x.kirkwood-murphy@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	10/28/2021	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Coordination of Benefits Contact	Senior Director		Chung	Clarence		1-562-390-9293				1-562-658-3866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Customer Service Operations Contact	Sr Director Member Relations		Devers	Jason	C	1-323-302-7947				1-404-949-5001	jason.c.devers@kp.org	Nine Piedmont Center	3495 Piedmont Road, NE	Atlanta	GA	30305	10/28/2021	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Government Relations Contact	Manager, Government Relations		Ross	Shea		1-706-224-8939				1-404-364-4136	shea.ross@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	09/06/2017	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Medicare Compliance Officer	Medicare Contract Compliance Manager	Ms.	Walden	Chandra		1-404-985-0135					chandra.walden@kp.org	3495 Piedmont Road	Nine Piedmont Center	Atlanta	GA	30305-1736	01/13/2021	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Part D Exceptions Contact	Manager, Pharmacy Benefits and Training		Gosnell	Nicole							nicole.gosnell@kp.org	3495 Piedmont Road NE	Ten Piedmont Center	Atlanta	GA	30305	10/20/2009	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-800-232-4404				HMO - Health Maintenance Organization		C	San Francisco
H1170	Pharmacy Network Management Contact	Pharmacy Benefits Manager		Gosnell	Nicole		1-404-364-7120					nicole.gosnell@kp.org	3495 Piedmont Road NE	Ten Piedmont Center	Atlanta	GA	30305	01/13/2012	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1170	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Okalahoma City	OK	73104	11/02/2016	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-888-277-3914				HMO - Health Maintenance Organization		C	San Francisco
H1170	Plan to Plan Reconciliation Contact	Director, National Medicare & Medicaid Finance		Callender	Margaret		1-510-433-6709					margaret.callender@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	08/14/2017	2023	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1181	Chief Financial Officer	Chief Financial Officere	Mr	Ollech	Brian		1-920-720-1886					bollech@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	CMS Casework Communication Contact	Director, Regulatory Affairs		Schuster	Shannon		1-920-628-7267					sschuste@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Customer Service Operations Contact	Manager, Customer Service		Schwandner	Stacy		1-920-720-1309				1-920-720-1908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Government Relations Contact	Compliance Officer		Keenan	Angela		1-920-720-1242					nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Medicare Compliance Officer	Compliance Officer	Mrs.	Keenan	Angela		1-920-720-1242				1-920-720-1912	nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1189	Automated TrOOP Balance Transfer Contact	Director of Finance		Orr	Raven		1-469-282-3217					raven.orr@christushealth.org	919 Hidden Ridge		Irving	TX	75038	03/26/2021	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Best Available Evidence Contact	Enrollment Manager		Satchell	DeMaurea		1-469-282-3224					Demaurea.Satchell@christushealh.org	909 Hidden Ridge		Irving	TX	75038	12/20/2022	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Chief Financial Officer	CEO Christus Health Plan	Mr.	Stansbury	Shannon		1-469-282-3337					shannon.stansbury@christushealth.org	919 Hidden Ridge		Irving	TX	75038	10/14/2022	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	CMS Casework Communication Contact	Manager-Appeals and Grievances		Hendon	Amanda		1-469-282-3039				1-866-416-2840	amanda.hendon@christushealth.org	919 Hidden Ridge		Irving	TX	75038	06/30/2022	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Coordination of Benefits Contact	Manager Claims	Mrs.	Grado	Sandra		1-469-282-3200					sandra.grado@christushealth.org	919 Hidden Ridge		Irving	TX	75038	04/14/2022	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Customer Service Operations Contact	Director Health Plans	Ms.	Horn	Jeniffer		1-469-282-3252					jen.horn@christushealth.org	919 Hidden Ridge		Irving	TX	75038	10/13/2022	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Government Relations Contact	Chief Administrative Officer	Ms.	Hefton	Ronda		1-469-282-3330					ronda.hefton@christushealth.org	909 Hidden Ridge		Irving	TX	75038	12/08/2021	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Hospice Contact	Director of Medical Management		Britton	Jana		1-469-394-5100					jana.britton@christushealth.org	919 Hidden Ridge		Irving	TX	75038	10/14/2022	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Medicare Compliance Officer	Director of Health Plan CMS Compliance	Mrs.	Chavez	Rocio		1-469-282-3523					rocio.chavez@christushealth.org	919 Hidden Ridge		Irving	TX	75038	10/13/2022	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian							brian_schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	04/28/2016	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active	1-800-344-3405	3363326			HMO - Health Maintenance Organization		C	Dallas
H1189	Pharmacy Network Management Contact	Director, Retail & Strategy Contracting		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	07/28/2021	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1189	Pharmacy Technical Help Desk Contact	Director of Operations,		Liu	Ian							iliu@express-scripts.com	6625 West 78th		Minneapolis	MN	55439	02/18/2019	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Dallas
H1189	Plan to Plan Reconciliation Contact	CEO Christus Health Plan	Mr.	Stansbury	Shannon		1-469-282-3337					shannon.stansbury@christushealth.org	919 Hidden Ridge		Irving	TX	75038	10/14/2022	2023	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Plan Generations	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/24/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/03/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/24/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H1215	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/24/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1215	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	Envolve						1-877-386-4695	everzino@centene.com	5 River Park Place East	Suite 210	Fresno	CA	93720	03/24/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-866-399-0928				HMO - Health Maintenance Organization		C	Dallas
H1215	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/03/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1224	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility	Ms.	Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Best Available Evidence Contact	Chief Compliance Officer	Mr.	Mapp	Thomas		1-202-340-3132					LACareComplianceOfficer@lacare.org	1055 West 7th Street	10th floor	Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Chief Financial Officer	Chief Financial Officer	Ms.	Montgomery	Marie		1-508-397-9179					MMontgomery@lacare.org	1055 West 7th Street	10th Floor	Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	CMS Casework Communication Contact	Director Customer Solution Center Appeals	Ms.	Crandall	Demetra		1-213-694-1250	4616				A&G_Intake@lacare.org	1055 West 7th Street		Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Coordination of Benefits Contact	Lead Product Solutions Manager, Medicare Product	Ms.	Tisdale	Mona		1-213-392-6050					mtisdale@lacare.org	1055 West 7th Street	10th floor	Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Customer Service Operations Contact	Senior Director, Customer Solutions	Ms.	Tham	Jackie		1-917-502-8215					JTham@lacare.org	1055 West 7th Street	10th Floor	Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Government Relations Contact	Compliance Advisor III	Ms.	Alsawaf	Surah		1-213-503-1454					lacarecomplianceofficer@lacare.org	1055 West 7th Street		Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Hospice Contact	Manager Technical Operations		Moussa	Nicole		1-213-248-8246					nmoussa@lacare.org	1055 West 7th Street		Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Mapp	Thomas		1-202-340-3132					LACareComplianceOfficer@lacare.org	1055 West 7th Street	10th floor	Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Part D Exceptions Contact	Senior Manager, Clinical Prior Authorization	Mr.	LeClair	Chris						1-920-221-4622	christopher.leclair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active	1-920-221-4122				HMO - Health Maintenance Organization		C	San Francisco
H1224	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	jan.robinson@navitus.com	361 Integrity Drive		Madison	WI	53717	04/15/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1224	Pharmacy Technical Help Desk Contact	Dedicated Help Desk		Help Line	Navitus						1-855-878-9207	danielle.nett@navitus.com	P.O Box 1039		Appleton	WI	54912	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active	1-844-268-9785				HMO - Health Maintenance Organization		C	San Francisco
H1224	Plan to Plan Reconciliation Contact	Senior Director Medical Payment Systems	Ms.	Mora	Priscilla		1-213-694-1250	4236				pmora@lacare.org	1055 West 7th Street	10th Floor	Los Angeles	CA	90017	01/05/2022	2023	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS		Local Initiative Health Authority for LA County	334	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1225	Automated TrOOP Balance Transfer Contact	AVP Pharmacy	Mr.	Fatodu	Hugh		1-410-424-4671				1-410-424-4671	fatoduh@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Best Available Evidence Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		1-863-634-1202					sriaz@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/17/2022	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Chief Financial Officer	Chief Financial Officer	Mr.	Chojnowski	Daniel		1-207-807-2496					DChojnowski@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/19/2021	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	CMS Casework Communication Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		1-443-618-0786					MDonnelly@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	01/25/2022	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Coordination of Benefits Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		1-863-634-1202					Sriaz@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/17/2022	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Customer Service Operations Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		1-863-634-1202					Sriaz@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/17/2022	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Government Relations Contact	President Medicare Advantage	Ms.	Wilson	Marja		1-360-306-1205					MWilson@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/20/2021	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Hospice Contact	Medicare Part D Pharmacy Manager	Ms.	Wexler	Mary Beth		1-410-762-5938					MBWexler@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Donnelly	Mary		1-443-618-0786					MDonnelly@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/31/2020	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Part D Exceptions Contact	Director, Pharmacy	Ms.	Gazy	Nahid						1-410-762-1521	ngazy@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	1-800-261-2396				HMO - Health Maintenance Organization		C	Philadelphia
H1225	Pharmacy Network Management Contact	AVP Pharmacy	Mr.	Fatodu	Hugh		1-410-424-4671				1-410-424-4671	fatoduh@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1225	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Ms.	Gazy	Nahid						1-410-762-1521	ngazy@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Philadelphia
H1225	Plan to Plan Reconciliation Contact	Associate Vice President Finance	Mr.	Magee	Ryan		1-410-424-4948					rmagee@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1228	Automated TrOOP Balance Transfer Contact	Health Plan Specialist		Carr	Terrylyn		1-209-724-6000	6001			1-209-724-6001	tcarr@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Best Available Evidence Contact	Medical Director	Dr	Dunitz	Neal		1-209-724-6000				1-209-724-6001	ndunitz@gvhc.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Chief Financial Officer	CFO	Ms	Sandhu	Gurjeet		1-209-384-6516				1-209-383-0136	gsandhu@gvhc.org	2926 G St		Merced	CA	95340	05/08/2020	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	CMS Casework Communication Contact	Quality and Safety Manager		Porras	Eva	M	1-209-724-6000				1-209-724-6001	eporras@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	09/02/2022	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Coordination of Benefits Contact	Health Plan Specialist		Carr	Terrylyn		1-209-724-6000	6001			1-209-724-6001	tcarr@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Customer Service Operations Contact	Health Plan Specialist		Carr	Terrylyn		1-209-724-6000	6001			1-209-724-6001	tcarr@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Government Relations Contact	Executive Director		West	Jason		1-209-724-6000				1-209-724-6001	jwest@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Medicare Compliance Officer	Executive Director	Mr	West	Jason		1-209-384-6529				1-209-724-6001	jwest@cvpace.org	2401 East Orangeburg	Suite 330	Modesto	CA	95355	12/15/2020	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Part D Exceptions Contact	Health Plan Specialist		Carr	Terrylyn						1-209-724-6001	tcarr@cvpace.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active	1-855-461-7223	6001			PACE - Nat		C	San Francisco
H1228	Pharmacy Network Management Contact	Health Plan Specialist		Carr	Terrylyn		1-209-724-6000	6000			1-209-724-6001	tcarr@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Pharmacy Technical Help Desk Contact	Health Plan Specialist		Carr	Terrylyn						1-209-724-6001	tcarr@gvhc.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active	1-855-461-7223	6001			PACE - Nat		C	San Francisco
H1228	Plan to Plan Reconciliation Contact	Health Plan Specialist		Carr	Terrylyn		1-209-724-6000	6001			1-209-724-6001	tcarr@cvpace.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	01/05/2021	2023	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1230	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	1-562-367-0592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Chief Financial Officer	Vice President & Chief Financial Officer	Ms.	Shepler	Courtney	R	1-510-271-4644					courtney.r.shepler@kp.org	National Medicare Finance, 1 Kaiser Plaza, 13th Floor	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	05/17/2017	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	CMS Casework Communication Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		1-206-473-9504				1-206-877-0645	Kimberly.C.Piper@kp.org	PO Box 9813, Bldg RCB, Mail Stop RCB-C3W-08	1300 SW 27th St, Bldg RCB, Mail Stop RCB-C3W-08	Renton	WA	98057-9055	10/05/2021	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Coordination of Benefits Contact	Senior Director		Chung	Clarence		1-562-390-9293				1-562-658-3866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Customer Service Operations Contact	Director, Customer Service and Appeals		Devol	Michele		1-808-432-5215				1-808-432-5667	michelle.j.devol@kp.org	711 Kapiolani Blvd		Honolulu	HI	96813	11/05/2019	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Government Relations Contact	Senior Vice President, Government Relations	Mr.	Barrueta	Anthony	A	1-510-271-6835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/07/2021	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Piper	Kimberly	C	1-206-473-9504				1-206-877-0645	Kimberly.C.Piper@kp.org	PO Box 9813, Bldg RCB, Mail Stop RCB-C3W-08	1300 SW 27th St, Bldg RCB, Mail Stop RCB-C3W-08	Renton	WA	98057-9055	07/29/2021	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Part D Exceptions Contact	Pharmacy Benefits		Goo	Jeilyn	S						jeilyn.s.goo@kp.org	Kaiser Permanente Pharmacy Services	501 Alakawa St., Suite 101	Honolulu	HI	96817	03/24/2011	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-800-805-2739				HMO - Health Maintenance Organization		C	San Francisco
H1230	Pharmacy Network Management Contact	Pharmacy Benefits		Goo	Jeilyn		1-808-432-5534					jeilyn.s.goo@kp.org	Kaiser Permanente - Pharmacy Services	501 Alakawa Street	Honolulu	HI	96817	04/01/2013	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1230	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	11/02/2016	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-888-277-3917				HMO - Health Maintenance Organization		C	San Francisco
H1230	Plan to Plan Reconciliation Contact	Director, National Medicare & Medicaid Finance		Callender	Margaret		1-510-433-6709					margaret.callender@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	08/14/2017	2023	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1234	Automated TrOOP Balance Transfer Contact	Accounting Manager	Mr.	Stern	Gregg		1-609-599-5474				1-609-599-6203	gregg.stern@stfrancismedical.org	7500 K Johnson Blvd.		Bordentown	NJ	08505	02/17/2022	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	Best Available Evidence Contact	Executive Director	Mrs	zavorski	lisa		1-609-599-5478				1-609-599-6203	lzavorski@stfrancismedical.org	7500 K Johnson Blvd		Bordentown	NJ	08505	07/25/2018	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	Chief Financial Officer	Accounting Manager	Mr	Stern	Gregg		1-609-599-5474					gregg.stern@stfrancismedical.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	10/19/2022	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	CMS Casework Communication Contact	Executive Director	Mrs	zavorski	lisa		1-609-599-5478				1-609-599-6203	lzavorski@stfrancismedical.org	7500 K Johnson Blvd		Bordentown	NJ	08505	07/25/2018	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	Coordination of Benefits Contact	Accounting Manager	mr	stern	gregg		1-609-599-5474				1-609-599-6203	gregg.stern@stfrancismedical.org	7500 K Johnson Blvd		Bordentown	NJ	08505	07/25/2018	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	Customer Service Operations Contact	Executive Director	Ms.	Zavorski	Lisa		1-609-599-5478				1-609-599-6203	lzavorski@stfrancismedical.org	7500 K Johnson Blvd		Bordentown	NJ	08505	03/13/2017	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	Government Relations Contact	Executive Director	Ms.	Zavorski	Lisa		1-609-599-5478				1-609-599-6203	lzavorski@stfrancismedical.org	7500 K Johnson Blvd		Bordentown	NJ	08505	03/13/2017	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms.	Hays McElroy	Carrie	M	1-734-343-2668					Carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	10/27/2022	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	Part D Exceptions Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 South Broad Street		Philadelphia	PA	19145	12/31/2020	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	New York
H1234	Pharmacy Network Management Contact	executive director	mrs	zavorski	lisa		1-609-599-5478				1-609-599-6203	lzavorski@stfrancismedical.org	7500 K Johnson Blvd		Bordentown	NJ	08505	07/25/2018	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1234	Pharmacy Technical Help Desk Contact	executive director	mrs	zavorski	lisa						1-609-599-6203	lzavorski@stfrancismedical.org	7500 K Johnson Blvd		Bordentown	NJ	08505	07/25/2018	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active	1-609-599-5478				PACE - Nat		C	New York
H1234	Plan to Plan Reconciliation Contact	accounting manager	mr	stern	gregg		1-609-599-5474				1-609-599-6203	gregg.stern@stfrancismedical.org	7500 K Johnson Blvd		Bordentown	NJ	08505	07/25/2018	2023	LIFE ST. FRANCIS	National PACE	LIFE St. Francis	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H1239	Automated TrOOP Balance Transfer Contact	Director, PACE Finance		Hewitt	Jessica		1-720-974-6767				1-303-996-1600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/28/2021	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-303-869-4664				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/13/2021	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	Chief Financial Officer	Chief Financial Officer	Ms.	Gutierrez	Barbara		1-303-869-4664				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	03/14/2018	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-720-789-6054				1-303-996-1600	epeak@myinnovage.com	750 E 6th St		Richmond	VA	23224	03/02/2021	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-303-869-4664				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/09/2020	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	Customer Service Operations Contact	COO		Boswell	Silvia		1-215-951-4433					sboswell@myinnovage.com	6970 Germantown Ave		Philadelphia	PA	19119	09/28/2021	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	Government Relations Contact	Executive VP Government Relations		Steckel	Carol		1-720-789-6157				1-303-996-1600	CSteckel@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/26/2022	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	Medicare Compliance Officer	VP of Pharmacy Services	Mrs	Chase	Darla		1-720-974-6785	000			1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	Part D Exceptions Contact	VP of Pharmacy Services	Ms.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Philadelphia
H1239	Pharmacy Network Management Contact	VP of Pharmacy Services	Mr	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1239	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Mrs	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Philadelphia
H1239	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-303-869-4664				1-720-917-3390	AKizewski@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/13/2021	2023	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H1248	Automated TrOOP Balance Transfer Contact	Controller	Ms.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 Desiard Street	#300	Monroe	LA	71201	12/30/2020	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Best Available Evidence Contact	Medicare Enrollment Supervisor	Ms.	Brasher	Michele		1-318-998-3083					mbrasher@vhpla.com	130 Desiard Street	#300	Monroe	LA	71201	12/30/2020	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Chief Financial Officer	Chief Financial Officer	Mr.	Short	Adam		1-225-295-2189					adam.short@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	03/07/2022	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	CMS Casework Communication Contact	SVP and COO, Government Business	Mr.	Faulk	Sheldon		1-225-295-2079					sheldon.faulk@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/07/2018	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Coordination of Benefits Contact	Medicare Enrollment Supervisor	Ms.	Brasher	Michele		1-318-998-3083					mbrasher@vhpla.com	130 Desiard Street		Monroe	LA	71201	12/30/2020	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Customer Service Operations Contact	Director of Member Services	Ms.	Trichel	Amy		1-318-998-2870					atrichel@vhpla.com	130 Desiard Street		Monroe	LA	71201	12/30/2020	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Government Relations Contact	Director, Medicare Advantage Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					macompliance@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	05/06/2020	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Hospice Contact	Account Manager - Express Scripts	Ms.	Morgan	Stacy		1-480-281-8763					slmorgan@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	12/30/2020	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Medicare Compliance Officer	Director, Medicare Advantage Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					wesley.miller@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	05/06/2020	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian							Brian_Schumm@Express-Scripts.com	5151 Blazer Memorial Parkway		Dublin	OH	43017	02/14/2018	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-800-344-3405	733326			PPO - BBA		C	Dallas
H1248	Pharmacy Network Management Contact	Network Account Dir, Retail Strategy & Contracting	Ms.	Kelly	Heather		1-314-692-1866					Hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	02/14/2018	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1248	Pharmacy Technical Help Desk Contact	Sr. Manager - Memeber Services Contact Center		McVey	Darcheena							Darcheena_McVey@express-scripts.com	1640 Century Center Pkwy		Memphis	TN	38134	08/07/2018	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-800-922-1557				PPO - BBA		C	Dallas
H1248	Plan to Plan Reconciliation Contact	Senior Accountant, Financial Reporting	Ms.	Brown	Leigh Ann		1-225-953-3055					Leigh-Ann.Brown@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	02/23/2021	2023	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active					PPO - BBA		C	Dallas
H1277	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/24/2019	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/27/2022	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	06/21/2022	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/24/2019	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/20/2021	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/20/2021	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		1-615-481-1897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	08/10/2022	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/20/2021	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Philadelphia
H1277	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/20/2021	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1277	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Philadelphia
H1277	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	ALIGN SENIOR CARE, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1278	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H1278	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1278	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H1278	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1280	Automated TrOOP Balance Transfer Contact	Pharmacy Director		Wingerchuk	Caron		1-480-492-3852					caron.wingerchuk@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Best Available Evidence Contact	Pharmacy Director		Wingerchuk	Caron		1-480-492-3852					caron.wingerchuk@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Chief Financial Officer		Mr.	Lawless	Tom		1-608-509-1628					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	11/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	CMS Casework Communication Contact	Medical Director	Dr.	Lingisetty	Chandra		1-501-817-1428					chandra.lingisetty@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Coordination of Benefits Contact	VP of Finance		Texeria	Edward		1-617-665-7430					edward.texeria@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Customer Service Operations Contact			Cunniffe	Tom		1-617-299-3367					thomas.cunniffe@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	11/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Government Relations Contact	CCO		Price	John		1-215-880-6876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	09/16/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Hospice Contact	Medical Director	Dr.	Lingisetty	Chandra		1-501-817-1428					chandra.lingisetty@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Price	John		1-215-880-6876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Part D Exceptions Contact	Manager		Bricker	Bryce							bryce.m.bricker@optum.com	2441 Warrenville Road		Lisle	IL	60532	11/02/2021	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	1-612-632-6838				HMO - Health Maintenance Organization		C	New York
H1280	Pharmacy Network Management Contact	Director		Ashby	JoLynn		1-763-732-6364					JAshby@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	11/02/2021	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1280	Pharmacy Technical Help Desk Contact	Manager		Summers	Todd							Todd.summers@optum.com	755 Research Parkway		Oklahoma City	OK	73104	05/05/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	1-800-797-9791				HMO - Health Maintenance Organization		C	New York
H1280	Plan to Plan Reconciliation Contact	VP of Finance		Texeria	Edward		1-617-665-7430					edward.texeria@eternalhealth.com	31 St. James Ave.	Suite 950,	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH,INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	02/09/2018	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	04/12/2022	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	06/10/2022	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	06/10/2022	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	04/12/2022	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	01/04/2022	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	01/24/2022	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	04/11/2022	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	02/09/2018	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	02/19/2021	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H1290	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	02/09/2018	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1290	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	01/09/2019	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H1290	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	06/10/2022	2023	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1302	Automated TrOOP Balance Transfer Contact	Quality Improvement Performance Specialist		Kober	Ashley		1-986-224-3495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	02/16/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Best Available Evidence Contact	VP Compliance Medicare Compliance Officer		Thornock	Wade		1-986-224-6949					wade.thornock@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/28/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Chief Financial Officer	EVP Finance/CFO	Mr.	Ward	Dave		1-986-224-3438					dave.ward@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	10/12/2021	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	CMS Casework Communication Contact	Manager  Grievances & Appeals		Aharoni	Michelle		1-986-224-6604					michelle.aharoni@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	10/03/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Coordination of Benefits Contact			Service	Customer		1-208-395-8200					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/14/2021	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Customer Service Operations Contact	Customer Service Director		Davis	Natasha		1-986-224-6973					natasha.davis@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/14/2021	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Government Relations Contact	Medicare Compliance Officer		Thornock	Wade		1-986-224-6949					wade.thornock@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/28/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Hospice Contact	Clinical Pharmacist		Hymel	Matthew		1-986-224-4539					Matthew.Hymel@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/14/2021	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Medicare Compliance Officer	VP Compliance Medicare Compliance Officer	Mr.	Thornock	Wade		1-986-224-6949					wade.thornock@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	12/09/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Part D Exceptions Contact	VP Member and Provider Experience		Rothman	Alana							alana.rothman@ingenio-rx.com	6763 Strifler Place		Cincinnati	OH	45243	02/16/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active	1-513-336-3352				PPO - BBA		C	Seattle
H1302	Pharmacy Network Management Contact	Program Manager		De Leon	Rosanna		1-201-241-1560					Rosanna.DeLeon@Ingenio-Rx.com	2 Speedwell Avenue		Morristown	NJ	07960	02/16/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1302	Pharmacy Technical Help Desk Contact	Program Manager		De Leon	Rosanna							Rosanna.DeLeon@Ingenio-Rx.com	2 Speedwell Avenue		Morristown	NJ	07960	02/16/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active	1-833-377-4266				PPO - BBA		C	Seattle
H1302	Plan to Plan Reconciliation Contact	Quality Improvement Performance Specialist		Kober	Ashley		1-986-224-3495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	02/16/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					PPO - BBA		C	Seattle
H1304	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	12/07/2015	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				PPO - BBA		C	Seattle
H1304	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1304	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				PPO - BBA		C	Seattle
H1304	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield Of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H1310	Automated TrOOP Balance Transfer Contact	Director of IDT Operations	Ms.	Lueth	Alexandria		1-269-888-6108					a.lueth@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	06/29/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	Best Available Evidence Contact	Director of IDT Operations	Ms.	Lueth	Alexandria		1-269-888-6108					a.lueth@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	11/24/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	Chief Financial Officer	Director of Finance	Mr.	Witt	Matt		1-269-888-6106					m.witt@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	11/03/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	CMS Casework Communication Contact	Director of IDT Operations	Ms.	Lueth	Alexandria		1-269-888-6108					a.lueth@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	11/24/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	Coordination of Benefits Contact	Director of IDT Operations	Ms.	Lueth	Alexandria		1-269-888-6108					a.lueth@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	06/29/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	Customer Service Operations Contact	Director of IDT Operations	Ms.	Lueth	Alexandria		1-269-888-6108					a.lueth@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	06/29/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	Government Relations Contact	Chief Executive Officer	Ms.	Berglin	Sally		1-269-280-9446					s.berglin@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	11/24/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	Medicare Compliance Officer	Director of IDT Operations	Ms.	Lueth	Alexandria		1-269-888-6108					a.lueth@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	06/29/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	Part D Exceptions Contact	Director of Risk Management	Ms.	Lueth	Alexandria						1-269-441-9329	a.lueth@seniorcarepartnersmi.org	200 West Michigan Avenue	Suite 103	Battle Creek	MI	49017	03/08/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active	1-877-284-4071				PACE - Nat		C	Chicago
H1310	Pharmacy Network Management Contact	Lead Clinical Pharmacist	Ms.	Balazs	Gianna		1-269-488-5475					g.balazs@seniorcarepartnersmi.org	445 West Michigan Avenue		Kalamazoo	MI	49007	11/21/2019	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1310	Pharmacy Technical Help Desk Contact	Lead Clinical Pharmacist	Ms.	Balazs	Gianna							g.balazs@seniorcarepartnersmi.org	445 West Michigan Avenue		Kalamazoo	MI	49007	11/21/2019	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active	1-800-488-5860				PACE - Nat		C	Chicago
H1310	Plan to Plan Reconciliation Contact	Director of IDT Operations	Ms.	Lueth	Alexandria		1-269-888-6108					a.lueth@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	11/03/2021	2023	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active					PACE - Nat		C	Chicago
H1312	Automated TrOOP Balance Transfer Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	Best Available Evidence Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5810					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	Chief Financial Officer	Vice President of Finance	Ms.	Saxton	Kim		1-517-282-3826					saxtonk@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	CMS Casework Communication Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	Coordination of Benefits Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	Customer Service Operations Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	Government Relations Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	Part D Exceptions Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph							joseph.garbarino@mercyhealth.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending	1-215-339-4362				PACE - Nat		C	Dallas
H1312	Pharmacy Network Management Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1312	Pharmacy Technical Help Desk Contact	Regional Vice President of Operations	Mr.	Dias	Antonio							antonio.dias@trinity-health.org	710 Montegut St.		New Orleans	LA	70117	09/27/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending	1-917-703-5808				PACE - Nat		C	Dallas
H1312	Plan to Plan Reconciliation Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	09/26/2022	2023	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE				Yes	Pending					PACE - Nat		C	Dallas
H1347	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Coordinator		Stevens	William		1-205-220-2593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/13/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Best Available Evidence Contact	Sr. Business Analyst		Johnson	Geraldine		1-205-220-6077					gejohnson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Chief Financial Officer	SVP & Chief Financial Officer	Mr.	Carden	Noel		1-205-220-7741					ncarden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	CMS Casework Communication Contact	Senior Compliance Analyst		Jones	Kimberly		1-205-220-7077					kwjones@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Coordination of Benefits Contact	Manager Claims Processing		Davis	Lori		1-205-220-6265					Lori.Davis@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Customer Service Operations Contact	Dept Manager Customer Service		Pearson	Latreta		1-205-220-7905					llpearson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Government Relations Contact	Manager Product Management	Mrs	Kullman	Christy	M	1-205-220-5915					CKullman@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Hospice Contact	Pharmacy Operations Coordinator		Stevens	Andrew		1-205-220-2593					WStevens@BCBSAL.ORG	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Medicare Compliance Officer	Manager Corporate Compliance	Mr.	Gregg	Roger		1-205-220-7480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Part D Exceptions Contact	Regulatory Director		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/16/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	1-800-693-6651				PPO - BBA		C	Atlanta
H1347	Pharmacy Network Management Contact	Pharmacy Services Mgr		Matthews	Ginny		1-205-220-6558				1-205-403-4052	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1347	Pharmacy Technical Help Desk Contact	Pharmacy Services Mgr		Matthews	Ginny							Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	1-877-878-8668				PPO - BBA		C	Atlanta
H1347	Plan to Plan Reconciliation Contact	Sr. Analyst-Cash Management		Buford	Julie		1-205-220-7316					julie.buford@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	02/16/2022	2023	PATRIUS HEALTH INC	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	Atlanta
H1350	Automated TrOOP Balance Transfer Contact	Quality Improvement Performance Specialist		Kober	Ashley		1-986-224-3495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/14/2019	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Best Available Evidence Contact	MA EBS Supervisor Service Operations		Sherman	Missy		1-986-224-3236					Missy.Sherman@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/22/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Chief Financial Officer	Vice President and CFO	Mr.	Ward	David		1-986-224-3438					dave.ward@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	09/01/2021	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	CMS Casework Communication Contact	Manager  Grievances & Appeals		Aharoni	Michelle		1-986-224-6604					michelle.aharoni@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	10/03/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Coordination of Benefits Contact			Service	Customer		1-208-395-8200					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	09/17/2018	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Customer Service Operations Contact	Director ASO Operations		Davis	Natasha		1-986-224-6973					natasha.davis@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	02/15/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Government Relations Contact	Medicare Compliance Officer		Thornock	Wade		1-986-224-6949					wade.thornock@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/28/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Hospice Contact	Clinical Pharmacist Manager		Bohan	Jefferson		1-986-224-3708					jefferson.bohan@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	07/08/2021	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Medicare Compliance Officer	VP Compliance Medicare Compliance Officer	Mr.	Thornock	Wade		1-986-224-6949					wade.thornock@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	11/28/2022	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Part D Exceptions Contact	VP Member and Provider Experience		Rothman	Alana							alana.rothman@ingenio-rx.com	6763 Strifler Place		Cincinnati	OH	45243	12/29/2020	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active	1-513-336-3352				HMO - Health Maintenance Organization		C	Seattle
H1350	Pharmacy Network Management Contact	Program Manager		De Leon	Rosanna		1-201-241-1560					Rosanna.DeLeon@Ingenio-Rx.com	2 Speedwell Avenue		Morristown	NJ	07960	12/29/2020	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1350	Pharmacy Technical Help Desk Contact	Program Manager		De Leon	Rosanna							Rosanna.DeLeon@Ingenio-Rx.com	2 Speedwell Avenue		Morristown	NJ	07960	01/04/2021	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Seattle
H1350	Plan to Plan Reconciliation Contact	Quality Improvement Performance Specialist		Kober	Ashley		1-986-224-3495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/09/2018	2023	BLUE CROSS OF IDAHO CARE PLUS, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Blue Cross of Idaho Health Service, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1352	Automated TrOOP Balance Transfer Contact	Manager, Business Process		Diaz	Mario		1-949-475-3517					mario.diaz@optum.com	1100 Optum Circle		Eden Prairie	MN	55344	01/04/2021	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Best Available Evidence Contact	Director of Operations		Power	Donna		1-816-395-3259					Donna.Power@bluekc.com	2301 Main St		Kansas City	MO	64108	10/01/2020	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Chief Financial Officer		Mr.	Cournand	Henri		1-816-395-2323					Henri.Cournand@BlueKC.com	2301 Main Street		Kansas City	MO	64108	09/03/2019	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	CMS Casework Communication Contact			Muncy	Angela		1-816-395-3648					Angela.Muncy@BlueKC.com	2301 Main Street		Kansas City	MO	64108	07/23/2018	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Coordination of Benefits Contact			Phillips	Denise		1-816-395-2032					_MSP_COB@BlueKC.com	2301 Main Street		Kansas City	MO	64108	05/10/2022	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Customer Service Operations Contact	Director of Operations		Power	Donna		1-816-395-3259					Donna.Power@bluekc.com	2301 Main St		Kansas City	MO	64108	10/01/2020	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Government Relations Contact			Hoey	Yen		1-816-395-3664					yen.hoey@bluekc.com	2301 Main Street		Kansas City	MO	64108	09/03/2019	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Hospice Contact			McMenus	Cindy		1-816-395-2226					cindy.mcmenus@bluekc.com	2301 Main Street		Kansas City	MO	64108	12/31/2020	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Medicare Compliance Officer		Mrs.	Muncy	Angela		1-816-395-3648					Angela.Muncy@BlueKC.com	2301 Main Street		Kansas City	MO	64108	07/23/2018	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Part D Exceptions Contact			Bricker	Bryce							bryce.m.bricker@optum.com	9040 S. Rita Rd		Tucson	AZ	85747	12/31/2020	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active	1-612-632-6838				HMO - Health Maintenance Organization		C	Kansas City
H1352	Pharmacy Network Management Contact			Hagan	Kyle		1-303-989-5828					kyle.hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/31/2020	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1352	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Summers	Todd							todd.summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	12/27/2021	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active	1-866-443-1095				HMO - Health Maintenance Organization		C	Kansas City
H1352	Plan to Plan Reconciliation Contact	Accountant, Lead		Bresee	Mickey		1-816-395-3145					_P2P_Report@bluekc.com	2301 Main Street	ATTN: P2P Department	Kansas City	MO	64108	08/22/2022	2023	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Local CCP	Blue Medicare Advantage	HMO/HMOPOS		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1353	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/08/2022	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H1353	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1353	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H1353	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1357	Automated TrOOP Balance Transfer Contact	Health Plan Manager	Ms.	Joyce	Christina		1-336-746-3547				1-336-746-3565	cjoyce@EveryAge.org	802 East Center Street		Lexington	NC	27292	04/05/2022	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Best Available Evidence Contact	Executive Director	Mr.	Chang	Thomas		1-336-746-3500				1-336-746-3565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Chief Financial Officer	Chief Financial Officer	Mr.	White	John		1-828-465-8006				1-828-465-8015	jbwhite@EveryAge.org	100 Leonard Ave		Newton	NC	28658	08/26/2021	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	CMS Casework Communication Contact	Executive Director	Mr.	Chang	Thomas		1-336-746-3500				1-336-746-3565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Coordination of Benefits Contact	Health Plan Manager	Ms.	Joyce	Christina		1-336-746-3547				1-336-746-3565	cjoyce@EveryAge.org	802 East Center Street		Lexington	NC	27292	04/05/2022	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Customer Service Operations Contact	Quality Compliance Coordinator	Ms.	Pennington	Danielle		1-336-746-3513				1-336-746-3523	dpennington@EveryAge.org	802 East Center Street		Lexington	NC	27292	04/05/2022	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Government Relations Contact	Executive Director	Mr.	Chang	Thomas		1-336-746-3500				1-336-746-3565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Medicare Compliance Officer	Quality Compliance Coordinator	Ms.	Pennington	Danielle		1-336-746-3513				1-336-746-3523	dpennington@EveryAge.org	802 East Center Street		Lexington	NC	27292	04/05/2022	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Exceptions Contact	Executive Director	Mr.	Chang	Thomas						1-336-746-3565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active	1-833-223-4476				PACE - Nat		C	Atlanta
H1357	Pharmacy Network Management Contact	Health Plan Manager	Ms.	Joyce	Christina		1-336-746-3547				1-336-746-3565	cjoyce@EveryAge.org	802 East Center Street		Lexington	NC	27292	04/05/2022	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Pharmacy Technical Help Desk Contact	Executive Director	Mr.	Chang	Thomas						1-336-746-3565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active	1-833-223-4476				PACE - Nat		C	Atlanta
H1357	Plan to Plan Reconciliation Contact	Health Plan Manager	Ms.	Joyce	Christina		1-336-746-3547				1-336-746-3565	cjoyce@EveryAge.org	802 East Center Street		Lexington	NC	27292	04/05/2022	2023	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1360	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	09/15/2022	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H1360	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1360	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H1360	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1365	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Operations		Theriault	Anne		1-207-766-3144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	05/11/2021	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Best Available Evidence Contact	Manager, Member Operations		Whelan	James		1-207-274-2738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	12/08/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Chief Financial Officer	Chief Financial Officer	Ms	Jackson	Amanda		1-207-253-6115					amanda.jackson@martinspoint.org	331 Veranda Street	P. O.  Box 9746	Portland	ME	04104	06/25/2020	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	CMS Casework Communication Contact	Director Compliance & MCO		Loomis	Elizabeth		1-518-229-0535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	03/22/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Coordination of Benefits Contact	Manager, Member Operations		Whelan	James		1-207-274-2738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	04/07/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Customer Service Operations Contact	Director Compliance & MCO		Loomis	Elizabeth		1-518-229-0535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04101	03/22/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Government Relations Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		1-518-229-0535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	03/22/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Hospice Contact	Senior Medicare Part D Specialist		Creighton-Galinas	Sheila		1-207-828-2471					sheila.creighton-galinas@martinspoint.org	891 Washington Ave	PO Box 9746	Portland	ME	04104-5040	02/05/2018	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Medicare Compliance Officer	Director Compliance & MCO	Ms	Loomis	Elizabeth		1-518-229-0535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	03/22/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Part D Exceptions Contact	Appeals Representative		Representative	Appeals							appealsmedicare@caremark.com	CVS Caremark	9501 E. Shea Blvd MC 109	Scottsdale	AZ	85260	02/15/2011	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active	1-868-884-9479				PPO - BBA		C	New York
H1365	Pharmacy Network Management Contact	Director, Network Operations		Smith	Shawn		1-480-391-4844				1-480-314-6964	Shawn.Smith@caremark.com	CVS Caremark	9501 E. Shea Blvd. MC143	Scottsdale	AZ	85260	01/26/2015	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1365	Pharmacy Technical Help Desk Contact	Manager, Vendor Management		Palmieri	Mike							mike.palmieri@caremark.com	CVS Caremark	2401 Cherahala Blvd. MC650	Knoxville	TN	37932	11/21/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H1365	Plan to Plan Reconciliation Contact	Accountant III		Allard	Kathleen		1-207-828-2490					kathleen.allard@martinspoint.org	P. O. Box 9746	27 Northport Drive	Portland	ME	04104	06/15/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active					PPO - BBA		C	New York
H1372	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/31/2018	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/01/2019	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/13/2021	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Government Relations Contact	Age Right Compliance Officer		Kleckner	Patty		1-503-701-0202					patty.kleckner@agerightadvantage.com	4560 SE International Way		Milwaukie	OR	97222	06/22/2022	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/13/2021	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Medicare Compliance Officer		Ms.	Kleckner	Patty		1-503-701-0202					compliance@agerightadvantage.com	4560 SE International Way	#100	Milwaukie	OR	97222	04/25/2022	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/14/2021	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Seattle
H1372	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/13/2021	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Seattle
H1372	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1375	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/15/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/13/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H1375	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1375	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H1375	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/17/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1395	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/05/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H1395	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1395	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H1395	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/05/2021	2023	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1415	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Hospice Contact	Enrollment/Billing Manager	Ms	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H1415	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1415	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H1415	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1416	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H1416	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1416	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H1416	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1423	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	01/27/2022	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H1423	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-833-377-4266					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H1423	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	AMERIGROUP OHIO, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1426	Automated TrOOP Balance Transfer Contact			Manosca	Nova		1-858-790-5873					PartDCAT@Medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/09/2018	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Best Available Evidence Contact	Director, Enrollment, Recon. & Retention		Andrade	Remo		1-617-426-0600	7931				randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/12/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Chief Financial Officer	Chief Financial Officer	Ms.	Hamilton	Mary		1-857-327-1953					mahamilton@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	CMS Casework Communication Contact	Director, Appeals & Grievances	Mr.	Schenk	Tyrone		1-857-327-3320					tschenk@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/12/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Coordination of Benefits Contact	Director, Enrollment, Recon. & Retention		Andrade	Remo		1-617-426-0600	57931				randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/12/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Customer Service Operations Contact	VP Operations		Habib	Fred		1-617-426-0600	1504				fhabib@commonwealthcare.org	2 Avenue de Lafayette		Boston	MA	02111	12/13/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Government Relations Contact	VP, Government Relations		Preede	Ken		1-617-426-0600	51412				kpreede@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/30/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Hospice Contact	Palliative Care Medical Director		Ragland	Julia		1-781-525-4203					jragland@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	10/04/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	Lavallee	Katherine		1-617-947-5780					KLavalee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/01/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Part D Exceptions Contact	Director, Pharmacy	Ms	Berman	Tova							TBerman@commonwealthcare.org	30 Winter St		Boston	MA	02108	10/25/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-617-426-0600	51289			HMO - Health Maintenance Organization		C	Boston
H1426	Pharmacy Network Management Contact	Director of Pharmacy Services		Berman	Tova		1-617-655-4768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	10/25/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1426	Pharmacy Technical Help Desk Contact	VP, Customer Contact		Battle	Dorry							Customerservice@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/10/2018	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-888-254-9907				HMO - Health Maintenance Organization		C	Boston
H1426	Plan to Plan Reconciliation Contact	Accounts Receivable Coordinator		Newman	Elaine		1-617-426-0600	52580				enewman@commonwealthcare.org	30 Winter St		Boston	MA	02108	08/25/2022	2023	CCA HEALTH PLANS OF CALIFORNIA, INC.	Local CCP	CCA Health California	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1463	Automated TrOOP Balance Transfer Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Best Available Evidence Contact	Medicare Enrollment Manager		Kirby	Rae		1-217-902-9108					rae.kirby@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	11/22/2021	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Chief Financial Officer	Chief Financial Officer	Mr.	Bradford	Jerry		1-217-902-9002				1-217-902-9740	Jerry.Bradford@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	10/18/2021	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	CMS Casework Communication Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Coordination of Benefits Contact	Director of Claims & Recovery		Parker	Lisa		1-217-902-8353				1-217-902-9786	lisa.parker@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Customer Service Operations Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Government Relations Contact	CEO		Madigan	Sinead		1-217-902-8301				1-217-902-9740	sinead.madigan@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Hospice Contact	Director of Pharmacy		Buhr	Aimee		1-217-902-9366					Aimee.Buhr@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	11/22/2021	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Medicare Compliance Officer	VP, Chief Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Part D Exceptions Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active	1-217-902-8224				HMO - Health Maintenance Organization		C	Chicago
H1463	Pharmacy Network Management Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1463	Pharmacy Technical Help Desk Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active	1-844-265-1876				HMO - Health Maintenance Organization		C	Chicago
H1463	Plan to Plan Reconciliation Contact			Tizora	Elizabeth		1-217-902-9469					elizabeth.tizora@healthalliance.org	3310 Fields South Dr		Champaign	IL	61822	03/14/2019	2023	HEALTH ALLIANCE CONNECT, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1468	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H1468	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H1468	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1500	Automated TrOOP Balance Transfer Contact	Finance Manager		Olsen	Katie		1-910-429-7251				1-910-483-4930	Katie.Olsen@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	03/10/2020	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	Best Available Evidence Contact	Executive Director	Ms.	Alexander-Hines	Joyce		1-910-429-7202				1-910-483-4930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	Chief Financial Officer	Executive Director	Mrs	Alexander-Hines	Joyce		1-910-429-7202					joyce.alexander-hines@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	10/03/2022	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	CMS Casework Communication Contact	Executive Director	Ms.	Alexander-Hines	Joyce		1-910-429-7202				1-910-483-4930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	Coordination of Benefits Contact	Business Office Coordinator	Mrs.	Reed	Melissa		1-910-429-7204				1-910-483-4930	Melissa.Reed001@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	09/13/2019	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	Customer Service Operations Contact	Executive Director	Ms.	Alexander-Hines	Joyce		1-910-429-7202				1-910-483-4930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	Government Relations Contact	Executive Director	Ms.	Alexander-Hines	Joyce		1-910-429-7202				1-910-483-4930	Joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Mrs	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/22/2020	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	Part D Exceptions Contact	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 Broad Street		Philadelphia	PA	19145	12/31/2020	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Atlanta
H1500	Pharmacy Network Management Contact	Executive Director	Ms.	Alexander-Hines	Joyce		1-910-429-7202				1-910-483-4930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1500	Pharmacy Technical Help Desk Contact	Executive Director	Ms.	Alexander-Hines	Joyce						1-800-910-4294	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active	1-180-042-9742				PACE - Nat		C	Atlanta
H1500	Plan to Plan Reconciliation Contact	Finance Manager		Olsen	Katie		1-910-429-7251				1-910-483-4930	Katie.Olsen@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	03/10/2020	2023	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H1518	Automated TrOOP Balance Transfer Contact	Executive Director	Ms.	Rudick	Ashley		1-716-819-5081				1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	03/11/2020	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	Best Available Evidence Contact	Executive Director	Ms.	Rudick	Ashley		1-716-819-5081				1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	03/11/2020	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	Chief Financial Officer	Vice President of Finance/Controller	Mr.	Edwards	Russell		1-716-923-2968					redwards@chsbuffalo.org	144 Genesee St.	4th Floor - Finance	Buffalo	NY	14203	08/09/2022	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	CMS Casework Communication Contact	Executive Director	Ms.	Rudick	Ashley		1-716-819-5081				1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	03/11/2020	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	Coordination of Benefits Contact	Executive Director	Ms.	Rudick	Ashley		1-716-819-5081				1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	03/11/2020	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	Customer Service Operations Contact	Executive Director	Ms.	Rudick	Ashley		1-716-819-5081				1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	03/11/2020	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	Government Relations Contact	Executive Director	Ms.	Rudick	Ashley		1-716-819-5081				1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	03/11/2020	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	Medicare Compliance Officer	Compliance & Privacy Officer	Mrs.	Whistler	Kimberly	E	1-716-821-4471					kwhistler@chsbuffalo.org	144 Genesee St	6th Floor	Buffalo	NY	14203	05/19/2022	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	Part D Exceptions Contact	Executive Director	Ms.	Rudick	Ashley						1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	09/24/2019	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active	1-855-671-3341				PACE - Nat		C	New York
H1518	Pharmacy Network Management Contact	Executive Director	Ms.	Rudick	Ashley		1-716-819-5081				1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	03/11/2020	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1518	Pharmacy Technical Help Desk Contact	Executive Director	Ms.	Rudick	Ashley						1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	09/24/2019	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active	1-855-671-3341				PACE - Nat		C	New York
H1518	Plan to Plan Reconciliation Contact	Executive Director	Ms.	Rudick	Ashley		1-716-819-5081				1-716-819-5099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	03/11/2020	2023	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1533	Automated TrOOP Balance Transfer Contact	Executive Director	Mrs	Martin	Karen		1-336-628-4200				1-336-628-4235	karen.martin@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Best Available Evidence Contact	Executive Director	Mrs	Martin	Karen		1-336-628-4200				1-336-628-4235	karen.martin@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Chief Financial Officer	Executive Director	Mrs	Martin	Karen		1-336-628-4200				1-336-628-4235	karen.martin@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	CMS Casework Communication Contact	Quality Assessment Performance Improvement Coor.	Mrs	Conrad	Janine		1-336-628-4215				1-336-628-4235	janine.conrad@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Coordination of Benefits Contact	Executive Director	Mrs	Martin	Karen		1-336-628-4200				1-336-628-4235	karen.martin@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Customer Service Operations Contact	Quality Assessment Performance Improvement Coor.	Mrs	Conrad	Janine		1-336-628-4200				1-336-628-4235	janine.conrad@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Government Relations Contact	Executive Director	Mrs	Martin	Karen		1-336-628-4200				1-336-628-4235	karen.martin@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Medicare Compliance Officer	Executive Director	Mrs	Martin	Karen		1-336-628-4200				1-336-628-4235	karen.martin@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Part D Exceptions Contact	Executive Director	Mrs	Martin	Karen						1-336-628-4235	karen.martin@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active	1-800-800-5555				PACE - Nat		C	Atlanta
H1533	Pharmacy Network Management Contact			Tanner	Robert		1-877-842-3210					rtanner@pharmastar.com	PO Box 3217		Eau Claire	WI	54702	11/21/2013	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Pharmacy Technical Help Desk Contact			Tanner	Robert							rtanner@pharmastar.com	PO Box 3217		Eau Claire	WI	54702	11/21/2013	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active	1-877-842-3210				PACE - Nat		C	Atlanta
H1533	Plan to Plan Reconciliation Contact	Executive Director	Mrs	Martin	Karen		1-336-628-4200				1-336-628-4235	karen.martin@randolphhealth.org	809 Curry Dr.		Asheboro	NC	27205	10/21/2019	2023	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1537	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H1537	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1537	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H1537	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1544	Automated TrOOP Balance Transfer Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Best Available Evidence Contact			Hall	Kristi		1-650-336-0300					kristi.hall@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	06/10/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Chief Financial Officer		Mr.	Epstein	Ethan		1-203-695-1178					ethan.epstein@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	CMS Casework Communication Contact			Goel	Jyotika		1-619-746-2459					jyotika.goel@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Coordination of Benefits Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Customer Service Operations Contact			Thiry	Matt		1-650-430-5157					matt.thiry@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Government Relations Contact			Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Medicare Compliance Officer		Ms.	Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part D Exceptions Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active	1-800-734-8041				PACE - Nat		C	San Francisco
H1544	Pharmacy Network Management Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Pharmacy Technical Help Desk Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active	1-800-734-8041				PACE - Nat		C	San Francisco
H1544	Plan to Plan Reconciliation Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	LA COAST PACE, LLC	National PACE	WelbeHealth Coastline PACE	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1587	Automated TrOOP Balance Transfer Contact	VP of Pharmacy Services	Dr.	Pardue	Lyndsey		1-501-590-0180					lpardue@superiorselectinc.com	1 Riverfront Place	Suite 600	N Little Rock	AR	72114	05/03/2022	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Best Available Evidence Contact	Member Service Manager		Stacy	Brittany		1-501-255-0873				1-866-705-3652	bstacy@access-healthservices.com	1 Riverfront Place	Suite 513A	North Little Rock	AR	72114	05/27/2022	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Chief Financial Officer	CFO/Director of Finance	Mr.	Gable	Alan		1-501-697-4560				1-501-372-1932	agable@superiorselectinc.com	1 Riverfront Place	Suite 600	North Little Rock	AR	72114	12/23/2020	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	CMS Casework Communication Contact	Medicare Compliance Officer	Mrs.	Morgan	Tara		1-501-944-2642				1-501-372-1932	tmorgan@superiorselectinc.com	1 Riverfront Place	Suite 600	North Little Rock	AR	72114	05/27/2022	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Coordination of Benefits Contact	VP of Pharmacy Services		Pardue	Lyndsey		1-501-590-0180					lpardue@superiorselectinc.com	1 Riverfront Place	Suite 600	N Little Rock	AR	72114	05/03/2022	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Customer Service Operations Contact	Member Service Manager		Stacy	Brittany		1-501-255-0873				1-866-705-3652	bstacy@access-healthservices.com	1 Riverfront Place	Suite 513A	North Little Rock	AR	72114	03/22/2018	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Government Relations Contact	Medicare Compliance Officer	Mrs.	Morgan	Tara		1-501-944-2642				1-501-372-1932	tmorgan@superiorselectinc.com	1 Riverfront Place	Suite 600	North Little Rock	AR	72114	05/27/2022	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Hospice Contact	Director of Quality and Utilization		Stone	Shana		1-501-690-2906					sstone@superiorselectinc.com	1 Riverfront Place	Suite 600	North Little Rock	AR	72114	12/23/2020	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Morgan	Tara		1-501-944-2642				1-501-372-1932	tmorgan@superiorselectinc.com	1 Riverfront Place	Suite 600	North Little Rock	AR	72114	01/14/2022	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Exceptions Contact	VP of Pharmacy Services		Pardue	Lyndsey							lpardue@superiorselectinc.com	1 Riverfront Place	Suite 600	N Little Rock	AR	72114	05/03/2022	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active	1-501-590-0180				HMO - Health Maintenance Organization		C	Dallas
H1587	Pharmacy Network Management Contact	Director of Pharmacy Network Contracting		Dyer	Tim		1-330-888-4812				1-330-405-8094	tdyer@envisionrx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	03/03/2016	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							tconn@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	07/07/2021	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active	1-833-502-6756				HMO - Health Maintenance Organization		C	Dallas
H1587	Plan to Plan Reconciliation Contact	CFO/Director of Finance	Mr.	Gable	Alan		1-501-697-4560				1-501-372-1932	agable@superiorselectinc.com	1 Riverfront Place	Suite 600	North Little Rock	AR	72114	12/23/2020	2023	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Tribute Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1607	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	01/27/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H1607	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1607	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H1607	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H1608	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/13/2020	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/22/2022	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/22/2022	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	12/19/2022	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-602-618-3945				PPO - BBA		C	Philadelphia
H1608	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/30/2022	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1608	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-800-238-6279				PPO - BBA		C	Philadelphia
H1608	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H1609	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/22/2022	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/22/2022	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/22/2022	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H1609	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/30/2022	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1609	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H1609	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	07/10/2020	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	05/04/2020	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	CMS Casework Communication Contact	Lead Director		Leskovac	Tara		1-614-563-7807					leskovact@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/20/2022	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Coordination of Benefits Contact	Director of Pharmacy		Stekol	Ilona		1-347-880-6082					StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	04/29/2022	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		1-866-600-2139					PhillipsL1@aetna.com	7400 Camous Road		New Albany	OH	43054	01/21/2020	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Government Relations Contact	Vice President, Duals Markets	Mr	Smith	Jason		1-614-551-4237					SmithT25@aetna.com	4500 E. Cotton Center Blvd.		Phoenix	AZ	85040	01/12/2022	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Hospice Contact	Director, Service Operations		Truitt	Michelle		1-717-671-6847					MLTruitt@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	07/01/2020	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Part D Exceptions Contact	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/05/2022	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-347-880-6082				HMO - Health Maintenance Organization		C	Philadelphia
H1610	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/30/2022	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1610	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	04/29/2022	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H1610	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1622	Automated TrOOP Balance Transfer Contact	PACE Program Director		Bernet	Janet		1-415-391-9686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	Best Available Evidence Contact	PACE Program Director		Bernet	Janet		1-415-391-9686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	Chief Financial Officer	Chief Financial Officer	Mr.	Wong	Johnson		1-650-550-3923					Johnson.Wong@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	09/25/2020	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	CMS Casework Communication Contact	PACE Program Director		Bernet	Janet		1-415-391-9686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	Coordination of Benefits Contact	PACE Program Director		Bernet	Janet		1-415-391-9686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	Customer Service Operations Contact	PACE Program Director		Bernet	Janet		1-415-391-9686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	Government Relations Contact	Privacy and Compliance Officer		Lim	Rebecca		1-415-352-5105					Rebecca.Lim@nems.org	2171 Junipero Serra	Suite 300	Daly City	CA	94014	02/25/2021	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	Medicare Compliance Officer	Privacy and Compliance Officer	Ms.	Lim	Rebecca		1-415-352-5105					Rebecca.Lim@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	02/18/2021	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	Part D Exceptions Contact	Pharmacist		Kwok	Calvin							calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active	1-415-352-5120				PACE - Nat		C	San Francisco
H1622	Pharmacy Network Management Contact	Director of Pharmacy		Chan	Beverley		1-415-352-5031					beverley.chan@nems.org	2171 Junipero Serra		Daly City	CA	94014	02/24/2021	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1622	Pharmacy Technical Help Desk Contact	Director of Pharmacy		Chan	Beverley							Beverley.Chan@nems.org	728 Pacific Avenue		San Francisco	CA	94133	02/24/2021	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active	1-415-352-5031				PACE - Nat		C	San Francisco
H1622	Plan to Plan Reconciliation Contact	PACE Program Director		Bernet	Janet		1-415-391-9686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2023	NORTH EAST MEDICAL SERVICES	National PACE	North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE)	National PACE		North East Medical Services	767	Yes	Active					PACE - Nat		C	San Francisco
H1644	Automated TrOOP Balance Transfer Contact			Rush	Jamie		1-561-690-1134					ESITroopTransfer@express-scripts.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Best Available Evidence Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N 107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Chief Financial Officer		Mr.	Granow	Les		1-561-444-0709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	CMS Casework Communication Contact			Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Coordination of Benefits Contact		Ms.	Burdelik	Dawn		1-561-815-3729					dawn.burdelik@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Customer Service Operations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Government Relations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Hospice Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Medicare Compliance Officer		Ms.	Lacey	Jennifer		1-813-367-7169					Jennifer.lacey@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						1-888-235-8551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-204-0016				HMO - Health Maintenance Organization		C	New York
H1644	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		1-800-204-0016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1644	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						1-888-235-8551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H1644	Plan to Plan Reconciliation Contact		Ms.	Zhai	Vicky		1-561-632-8915					Vicky.Zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1651	Chief Financial Officer	Director of Finance	Ms.	Mitchell	Jill		1-563-556-8070	4831			1-563-556-5134	jmitchell@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	01/03/2023	2023	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H1651	CMS Casework Communication Contact	Medicare Compliance Analyst		Digmann	Jodi	A	1-563-584-4836				1-563-556-5134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	02/11/2022	2023	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H1651	Customer Service Operations Contact	Member Services Supervisor		Boge	Laura		1-569-556-8070	4857			1-569-556-5134	lboge@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	05/20/2021	2023	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H1651	Government Relations Contact	Medicare Compliance Analyst		Digmann	Jodi	A	1-563-584-4836				1-563-556-5134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	02/11/2022	2023	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H1651	Medicare Compliance Officer	Director of Operations	Ms.	Hoffmann	Karen		1-563-556-8070	4817			1-563-556-5134	khoffman@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	05/20/2021	2023	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H1659	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	CMS Casework Communication Contact			Morton	Garland		1-434-947-4463	306				gmorton@pchp.net	2316 Atherholt Road		Lynchburg	VA	24501	11/08/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	10/04/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H1659	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1659	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H1659	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1664	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H1664	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1664	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H1664	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1666	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				PPO - BBA		C	Denver
H1666	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1666	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				PPO - BBA		C	Denver
H1666	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H1692	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/22/2022	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/22/2022	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/22/2022	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H1692	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/30/2022	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1692	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H1692	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H1693	Automated TrOOP Balance Transfer Contact	Financial Analyst		Macaranas	Drew		1-619-876-4416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	03/23/2020	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	Best Available Evidence Contact	PACE Benefit Plans Specialist		Rodriguez	Sachary		1-619-515-2300	7009				sacharyr@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/16/2022	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	Chief Financial Officer	Chief Financial Officer	Mr.	Roman	Ricardo		1-619-906-4603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	CMS Casework Communication Contact	Coordinator Quality Assurance		OKeefe	Emily		1-619-515-2300	7525				emilyo@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	12/29/2021	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	Coordination of Benefits Contact	PACE Benefit Plans Specialist		Rodriguez	Sasha		1-619-515-2445	7525				sacharyr@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	12/29/2021	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	Customer Service Operations Contact	Director PACE & Older Adult Services		Green	Kristofer		1-619-515-2300	4321				kristoferg@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	07/14/2022	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	Government Relations Contact	Sr. VP of Support Services		Gering	Jeffrey		1-619-363-1694					jeffreyg@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	12/29/2021	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	Medicare Compliance Officer	Chief Financial Officer	Mr.	Roman	Ricardo		1-619-906-4603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	Part D Exceptions Contact	Senior Vice President		Gering	Jeffrey							jeffreyg@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/25/2022	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active	1-619-515-2536				PACE - Nat		C	San Francisco
H1693	Pharmacy Network Management Contact	Chief Financial Officer		Roman	Ricardo		1-619-906-4603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1693	Pharmacy Technical Help Desk Contact	PACE Financial Analyst II		Macaranas	Drew							andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	07/14/2022	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active	1-619-515-2300	4416			PACE - Nat		C	San Francisco
H1693	Plan to Plan Reconciliation Contact	PACE Benefit Plans Specialist		Rodriguez	Sachary		1-619-598-2957					sacharyr@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	12/29/2021	2023	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	National PACE	Family Health-Center for Older Adults	National PACE		Family Health Centers of San Diego	717	Yes	Active					PACE - Nat		C	San Francisco
H1714	Automated TrOOP Balance Transfer Contact	Senior Director of Finance-PACE	Mr.	Vieu	George		1-708-478-7943				1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	10/21/2020	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	Best Available Evidence Contact	Medical Director	Dr.	Mahdi	Khalida		1-316-858-1111	45128				khalida.mahdi@ascension.org	2622 W. Central	Suite 101	Wichita	KS	67203	04/02/2018	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	Chief Financial Officer	Senior Director of Finance, PACE	Mr.	Vieu	George		1-708-478-7943					george.vieu@ascension.org	18927 Hickory Creek Drive	Suite 300	Mokena	IL	60448	05/24/2019	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	CMS Casework Communication Contact	Director of Quality Improvement	Ms.	Eagles	Amber		1-316-946-5136				1-316-946-5105	amber.eagles@ascension.org	2622 W. Central	Suite 101	Wichita	KS	67203	05/01/2018	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	Coordination of Benefits Contact	Accounting Assistant	Ms.	Kennedy	Susan		1-316-946-5270					Susan.Kennedy@ascension.org	2622 W. Central	Suite 101	Wichita	KS	67203	04/02/2018	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	Customer Service Operations Contact	Executive Director	Ms	Johnson	Melissa		1-316-946-5341				1-316-694-6510	melissa.johnson9@ascension.org	2622 W. Central, Suite 101		Wichita	KS	67203	03/22/2020	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	Government Relations Contact	Executive Director	Ms	Johnson	Melissa		1-316-946-5341				1-316-946-5106	melissa.johnson9@ascension.org	2622 W. Central, Suite 101		Wichita	KS	67203	03/22/2020	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	Medicare Compliance Officer	Director of Quality Improvement	Ms.	Eagles	Amber		1-316-207-2238					amber.eagles@ascension.org	2622 W. Central	Suite 101	Wichita	KS	67203	08/25/2020	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	Part D Exceptions Contact	Accounting and Financial Reporting Lead	Mr.	Vieu	George						1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	10/21/2020	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active	1-800-441-8883				PACE - Nat		C	Kansas City
H1714	Pharmacy Network Management Contact	Executive Director	Ms	Johnson	Melissa		1-316-946-5341				1-316-946-5106	melissa.johnson9@ascension.org	2622 W. Central, Suite 101		Wichita	KS	67203	03/22/2020	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1714	Pharmacy Technical Help Desk Contact	Executive Director	Ms	Johnson	Melissa						1-316-946-5106	melissa.johnson9@ascension.org	2622 W. Central, Suite 101		Wichita	KS	67203	03/22/2020	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active	1-316-946-5136				PACE - Nat		C	Kansas City
H1714	Plan to Plan Reconciliation Contact	Claims Manager		Stengele	Brett		1-815-529-1077				1-423-622-6048	Brett.Stengele@ascension.org	250 East 10st Street		Chattanoooga	TN	37402	03/14/2022	2023	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Kansas City
H1722	Automated TrOOP Balance Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Best Available Evidence Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Chief Financial Officer	Chief Financial Officer	Mr.	Bermel	John		1-212-479-2777					jbermel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	CMS Casework Communication Contact	Complaints Manager	Ms.	Gabriel	Charisse		1-646-767-5697					cgabriel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Coordination of Benefits Contact	Director, Payment Integrity Team	Ms.	Hutchinson	Chris		1-917-698-2415					chutchinson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Customer Service Operations Contact	VP,  Member Services	Ms.	O'Connor	Kimberly		1-212-801-1639					koconnor@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Government Relations Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		1-646-313-8967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Hospice Contact	Director, Pharmacy Operations	Ms.	Lee Brown	Hannah		1-646-429-3818					hleebrown@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Medicare Compliance Officer	Chief Compliance Officer & Head of Internal Audit	Mr.	Hackendorn	John		1-212-453-4495					jhackendorn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Part D Exceptions Contact	Director, Pharmacy Operations	Ms.	Lee Brown	Hannah							hleebrown@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	1-888-260-1010				HMO - Health Maintenance Organization		C	New York
H1722	Pharmacy Network Management Contact	Director, Pharmacy Operations	Mr.	Suri	Tarun		1-646-354-1168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1722	Pharmacy Technical Help Desk Contact	Director, Client Operations	Ms.	Dayoub	Joselyn							dayoubj@cvshealth.com	CVS Health	800 NW Chipman Rd, Ste 5830	Lees Summit	MO	64063	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H1722	Plan to Plan Reconciliation Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor	Attn:  Treasury Department	New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1723	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/24/2021	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/24/2021	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/24/2021	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1723	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	ABSOLUTE TOTAL CARE, INC.	Demo	Wellcare Prime by Absolute Total Care	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H1732	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	01/27/2022	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H1732	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1732	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H1732	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	HEALTHPLUS HP, LLC	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Automated TrOOP Balance Transfer Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Best Available Evidence Contact	Medicare Enrollment Manager		Kirby	Rae		1-217-902-9108					rae.kirby@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	11/23/2021	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Chief Financial Officer	Chief Financial Officer	Mr.	Bradford	Jerry		1-217-902-9002				1-217-902-9740	Jerry.Bradford@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	10/18/2021	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	CMS Casework Communication Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Coordination of Benefits Contact	Director of Claims & Recovery		Parker	Lisa		1-217-902-8353				1-217-902-9786	lisa.parker@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Customer Service Operations Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Government Relations Contact	CEO		Madigan	Sinead		1-217-902-8301				1-217-902-9740	sinead.madigan@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Hospice Contact	Director of Pharmacy		Buhr	Aimee		1-217-902-9366					Aimee.Buhr@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	11/24/2021	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Medicare Compliance Officer	VP, Chief Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Part D Exceptions Contact	Medicare Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	09/25/2019	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active	1-217-902-8224				HMO - Health Maintenance Organization		C	Chicago
H1737	Pharmacy Network Management Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1737	Pharmacy Technical Help Desk Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active	1-844-265-1876				HMO - Health Maintenance Organization		C	Chicago
H1737	Plan to Plan Reconciliation Contact			Tizora	Elizabeth		1-217-902-9469					elizabeth.tizora@healthalliance.org	3310 Fields South Dr		Champaign	IL	61822	03/14/2019	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1742	Automated TrOOP Balance Transfer Contact	Senior Director of Finance, PACE	Mr.	Vieu	George		1-708-478-7943					george.vieu@ascension.org	18927 Hickory Creek Drive	Suite 300	Mokena	IL	60448	06/03/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	Best Available Evidence Contact	Medical Director	Dr.	Harrison	Stephen		1-317-721-3768					stephen.harrison@ascension.org	4600 Edmundson Rd.		St. Louis	MO	63134	06/03/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	Chief Financial Officer	Senior Director of Finance, PACE	Mr.	Vieu	George		1-708-478-7943					george.vieu@ascension.org	18927 Hickory Creek Drive	Suite 300	Mokena	IL	60448	04/29/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	CMS Casework Communication Contact	Executive Director	Mr.	Welch	Jeremy		1-317-731-2615					jeremy.welch@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	04/29/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	Coordination of Benefits Contact	Executive Director	Mr.	Welch	Jeremy		1-317-754-4565					jeremy.welch@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/08/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	Customer Service Operations Contact	Executive Director	Mr.	Welch	Jeremy		1-317-731-2615					jeremy.welch@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	04/29/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	Government Relations Contact	Executive Director	Mr.	Welch	Jeremy		1-317-731-2615					jeremy.welch@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	04/29/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	Medicare Compliance Officer	Executive Director	Mr.	Welch	Jeremy		1-317-731-2615					jeremy.welch@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/08/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	Part D Exceptions Contact	Accounting and Financial Reporting Lead	Mr.	Vieu	George						1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	06/03/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending	1-800-441-8883				PACE - Nat		C	Chicago
H1742	Pharmacy Network Management Contact	Executive Director	Mr.	Welch	Jeremy		1-317-731-2615					jeremy.welch@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/03/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1742	Pharmacy Technical Help Desk Contact	Executive Director	Mr.	Welch	Jeremy							jeremy.welch@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/08/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending	1-833-949-3777				PACE - Nat		C	Chicago
H1742	Plan to Plan Reconciliation Contact	Executive Director	Mr.	Welch	Jeremy		1-317-731-2615					jeremy.welch@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/08/2022	2023	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H1748	Automated TrOOP Balance Transfer Contact	Chief Medical Officer	Dr	Caraballo	Darwin		1-404-965-5731					dcaraballo@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	12/13/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Best Available Evidence Contact	Chief Medical Officer	Dr	Cabrera	Edward		1-404-965-5731					ecabrera@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	08/09/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Chief Financial Officer	CEO/Chief Financial Officer	Ms	Roberts	Suzanna		1-470-303-9206					Sroberts@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	12/28/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	CMS Casework Communication Contact	Compliance Officer	Mr	Christy	Paul		1-813-444-8808				1-941-866-2319	pchristy@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	08/25/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Coordination of Benefits Contact	Chief Medical Officer	Dr	Caraballo	Darwin		1-404-965-5731					dcaraballo@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	12/13/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Customer Service Operations Contact	Chief Operating Officer	Mr	Merritt	Charles		1-404-965-5731					cmerritt@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	10/12/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Government Relations Contact	Chief Compliance Officer	Mr	Christy	Paul		1-813-444-8808				1-941-866-2319	pchristy@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	08/26/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Hospice Contact	Chief Medical Officer	Dr	Cabrera	Edward		1-404-965-5731					ecabrera@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	03/12/2021	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Medicare Compliance Officer	Chief Compliance Officer	Mr	Christy	Paul		1-813-444-8808				1-941-866-2319	pchristy@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	08/25/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Part D Exceptions Contact	Pharmacy Director	Dr	Dunham	Scott							sdunham@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	12/28/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active	1-724-831-6035				HMO - Health Maintenance Organization		C	Atlanta
H1748	Pharmacy Network Management Contact	Pharmacy Director	Dr	Dunham	Scott		1-724-831-6035					sdunham@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	12/13/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1748	Pharmacy Technical Help Desk Contact	Pharmacy Director	Dr	Dunham	Scott							sdunham@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	12/14/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active	1-833-684-7263				HMO - Health Maintenance Organization		C	Atlanta
H1748	Plan to Plan Reconciliation Contact	President/Chief Growth Officer	Mr	Muchnicki	Michael		1-404-965-5731					mmuchnicki@sonderhealthplans.com	6190 Powers Ferry Road	Suite 320	Atlanta	GA	30339	08/26/2022	2023	SONDER HEALTH PLANS, INC.	Local CCP	Sonder Health Plan, Inc.	HMO/HMOPOS		Avian Health Holdings, LLC	728	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1774	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/05/2020	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H1774	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1774	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H1774	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1777	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Services		Krupar	Roman		1-917-484-5060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Best Available Evidence Contact	VP, MCO		Fama	Victor		1-917-484-5055					vfama@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	11/19/2021	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Chief Financial Officer	Sr. Vice President, C.F.O	Ms	Covone	Annmarie		1-646-633-4702				1-646-633-4701	acovone@archcare.org	205 Lexington Ave.	2nd Floor	New York	NY	10016	04/04/2013	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	CMS Casework Communication Contact	VP, Managed Care Organization	Mr.	Fama	Victor		1-917-484-5055					vfama@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	10/24/2019	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Coordination of Benefits Contact	VP, Managed Care Organization		Fama	Victor		1-917-484-5055					vfama@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	10/24/2019	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Customer Service Operations Contact	Director, Customer Care		Swanger	Rachel		1-440-542-4056					Rachel.swanger@cvshealth.com	29100 Aurora Road		Solon	OH	44139	08/17/2020	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Government Relations Contact	VP, Managed Care Organization		Fama	Victor		1-917-484-5055					vfama@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	10/24/2019	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Hospice Contact	Director, Pharmacy Services	Mr.	Krupar	Roman		1-917-484-5060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Medicare Compliance Officer	Manager, Compliance	Ms.	McCosker	Elizabeth		1-917-484-9735					emccosker@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	10/20/2020	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Part D Exceptions Contact	Director, Medicare Clinical Operations		Patel	Nimesh							NimeshC.Patel@CVSCaremark.com	CVS Caremark Part D Services, LCC.	29100 Aurora Road	Solon	OH	44139	12/20/2012	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active	1-440-542-5770				HMO - Health Maintenance Organization		C	New York
H1777	Pharmacy Network Management Contact	Director, Network Systems & Standards		Tressler	Damon		1-480-391-4702				1-480-314-6023	damon.tressler@caremark.com	CVS Caremark Part D Services, LCC.	9501 E Shea Blvd., MC080	Scottsdale	AZ	85260	12/20/2012	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1777	Pharmacy Technical Help Desk Contact	Manager, Vendor Management		Palmieri	Mike						1-866-693-4620	Mike.Palmieri@caremark.com	CVS Caremark Part D Services, LCC.	2401 Cherahala Blvd., MC650	Knoxville	TN	37932	11/16/2021	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H1777	Plan to Plan Reconciliation Contact	Financial Analyst		Chan	Carol		1-646-633-4761				1-646-233-5745	cchan@archcare.org	205 Lexington Avenue, 2nd Floor	ArchCare Advantage - Finance	New York	NY	10016	10/28/2014	2023	CATHOLIC SPECIAL NEEDS PLAN, LLC	Local CCP	ArchCare Advantage	HMO/HMOPOS		Catholic Health Care System	317	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1787	Automated TrOOP Balance Transfer Contact	Senior Director of Government Programs	Ms.	Fuller	Rebecca		1-605-328-7007					rebecca.fuller@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Best Available Evidence Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Chief Financial Officer	Vice President of Finance	Mr.	Maude	Brian		1-605-328-6801					Brian.Maude@SanfordHealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	CMS Casework Communication Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		1-605-328-7182					aleesa.jansick@sanfordhealth.org	300 Cherapa place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Coordination of Benefits Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Customer Service Operations Contact	Director of Customer Service	Mr.	Ling	Ryan		1-605-312-7459					ryan.ling@sanfordhealth.org	300 N Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Government Relations Contact	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Hospice Contact	Director of Utilization Management	Ms.	Kanta	Misty		1-605-312-2788					misty.kanta@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Exceptions Contact	Manager, Prior Authorization	Ms.	Le	Christina						1-877-239-4565	rxsol_prior_auth_redirected_queue_DL@uhc.com	3515 Harbor Blvd		Costa Mesa	CA	92626	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	1-888-403-3398				HMO - Health Maintenance Organization		C	Dallas
H1787	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway	Suite 200	Schaumburg	IL	60173-6801	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	1-844-642-9090				HMO - Health Maintenance Organization		C	Dallas
H1787	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		1-605-312-9344					debora.harris@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	12/23/2022	2023	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1799	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Best Available Evidence Contact	Director, Medicare Programs		Wolf	Mackenzie		1-502-213-8986					Mackenzie.Wolf@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/14/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H1799	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1799	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H1799	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1821	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H1821	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1821	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H1821	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1822	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations and Formulary		Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/01/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Best Available Evidence Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		1-562-637-1234				1-562-989-5243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Chief Financial Officer	Controller	Ms.	Havai	Virginia		1-562-989-8300					vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	CMS Casework Communication Contact	Director, Reg Audit & Ent Mntrng		Cordova	Elizabeth		1-562-997-3131				1-562-989-5120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/18/2022	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Coordination of Benefits Contact	Director, Pharmacy Operations and Formulary	Ms.	Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/03/2022	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		1-562-997-1805				1-562-989-5181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Government Relations Contact	Sr. Vice President, Public & Government Affairs	Ms.	Morrell	Adrienne		1-202-349-9008				1-562-989-9439	amorrell@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Hospice Contact	Manager, Pharmacy Experience and Access	Mr.	Tran	Tri		1-562-308-2884				1-562-997-3196	TMTran@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	02/09/2022	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Medicare Compliance Officer	Compliance Officer	Ms.	Hawkins	Ginette		1-562-308-1195					GHawkins@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Part D Exceptions Contact	Senior Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/01/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	San Francisco
H1822	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/19/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1822	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy	STE 150	Temple Terrace''	FL	33637	12/01/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	San Francisco
H1822	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		1-562-989-8300				1-562-989-0101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2023	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Desert Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1846	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		1-614-546-3183				1-614-546-3131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		1-614-546-3222				1-614-546-3148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		1-614-546-3211				1-614-546-3131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	CMS Casework Communication Contact	Compliance Specialist	Mr.	Jordan	David	A	1-614-706-8474				1-614-234-8372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Customer Service Operations Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		1-614-546-3180				1-614-546-3132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Government Relations Contact	CEO	Mr	Randolph	John	C	1-614-546-3152				1-614-546-3131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		1-412-478-0244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part D Exceptions Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active	1-800-240-3851				PPO - BBA		C	Chicago
H1846	Pharmacy Network Management Contact	Director, Pharmacy	Mr	Turoff	Chris		1-614-403-0394					chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active	1-866-693-4620				PPO - BBA		C	Chicago
H1846	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1848	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H1848	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1848	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H1848	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1862	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H1862	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1862	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H1862	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1889	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/15/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/13/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H1889	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1889	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H1889	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/17/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H1894	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H1894	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H1894	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	AMERIGROUP WASHINGTON, INC.	Local CCP	AMERIGROUP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1904	Automated TrOOP Balance Transfer Contact	Director of Finance		McCauley	Bryan		1-504-941-6075					Bmccauley@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	Best Available Evidence Contact	Executive Director		Wootan	Kurt		1-504-227-3411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	Chief Financial Officer	Director of Finance	Mr	McCauley	Bryan		1-504-941-6075					Bmccauley@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	CMS Casework Communication Contact	Executive Director		Wootan	Kurt		1-504-227-3411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	Coordination of Benefits Contact	Executive Director	Mr.	Wootan	Kurt	D	1-504-227-3411					kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	Customer Service Operations Contact	Executive Director		Wootan	Kurt		1-504-227-3411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	Government Relations Contact	Executive Director		Wootan	Kurt		1-504-227-3411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	Medicare Compliance Officer	Director of Operations	Mrs	Ventura	Trisha	D	1-504-941-6053					Tventura@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	Part D Exceptions Contact	Director of Finance	Mr	McCauley	Bryan	D					1-504-941-6082	McCauley@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active	1-866-743-8778				PACE - Nat		C	Denver
H1904	Pharmacy Network Management Contact	Interim Executive Director		Wootan	Kurt		1-504-227-3411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	11/02/2021	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1904	Pharmacy Technical Help Desk Contact	Interim Executive Director	Mr	Wootan	Kurt	D					1-504-941-6082	Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	11/02/2021	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active	1-866-743-8778				PACE - Nat		C	Denver
H1904	Plan to Plan Reconciliation Contact	Director of Finance	Mr	McCauley	Bryan		1-504-941-6075					Bmccauley@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2023	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Denver
H1914	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H1914	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1914	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H1914	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H1924	Chief Financial Officer	Chief Financial Officer	Mr.	Sahin	Mete		1-703-282-5955					mete.sahin@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	08/23/2022	2023	LASSO HEALTHCARE INSURANCE COMPANY	MSA	Lasso Healthcare	MSA		Zing Health Consolidator, Inc	730	No	Active					MSA		C	Denver
H1924	CMS Casework Communication Contact	Director, Compliance Audit & Monitoring	Ms.	Gordon	Reneatha		1-312-809-7947					reneatha.gordon@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	08/23/2022	2023	LASSO HEALTHCARE INSURANCE COMPANY	MSA	Lasso Healthcare	MSA		Zing Health Consolidator, Inc	730	No	Active					MSA		C	Denver
H1924	Customer Service Operations Contact	V.P. Customer Service	Ms.	Coyle	Gina		1-312-809-8079	183			1-312-809-8079	gina.coyle@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	08/23/2022	2023	LASSO HEALTHCARE INSURANCE COMPANY	MSA	Lasso Healthcare	MSA		Zing Health Consolidator, Inc	730	No	Active					MSA		C	Denver
H1924	Government Relations Contact	Communication	Mr..	Martin	Stephen		1-312-205-7948	138				stephen.martin@myzing.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	LASSO HEALTHCARE INSURANCE COMPANY	MSA	Lasso Healthcare	MSA		Zing Health Consolidator, Inc	730	No	Active					MSA		C	Denver
H1924	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Matuszak	Russell		1-312-832-6676	292			1-312-832-6676	russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	LASSO HEALTHCARE INSURANCE COMPANY	MSA	Lasso Healthcare	MSA		Zing Health Consolidator, Inc	730	No	Active					MSA		C	Denver
H1944	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H1944	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1944	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H1944	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/22/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1947	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H1947	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1947	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H1947	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1951	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H1951	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1951	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H1951	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1961	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/17/2019	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Best Available Evidence Contact			Korndorffer	Gretchen		1-504-849-4500	8963				gretchen.korndorffer@peopleshealth.com	Three Lakeway Center	3838 North Causeway Boulevard, Suite 2200	Metairie	LA	70002	03/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	CMS Casework Communication Contact			Culotta	Dianne		1-504-849-4500	8672				dianne.culotta@peopleshealth.com	Three Lakeway Center	3838 North Causeway Boulevard, Suite 2200	Metairie	LA	70002	03/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Coordination of Benefits Contact			Kennedy	Sean		1-504-849-4500	8880				phn-pbmteam@peopleshealth.com	Three Lakeway Center	3838 North Causeway Boulevard, Suite 2200	Metairie	LA	70002	03/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Customer Service Operations Contact	Director of Customer Service		Miller	Cheryl		1-504-849-4500	8175				cheryl.miller@peopleshealth.com	Three Lakeway Center	3838 North Causeway Boulevard, Suite 2200	Metairie	LA	70002	04/22/2022	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/17/2019	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	06/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/17/2019	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H1961	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/17/2019	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1961	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	12/17/2019	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H1961	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	12/17/2019	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1969	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				HMO - Health Maintenance Organization		C	Seattle
H1969	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1969	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				HMO - Health Maintenance Organization		C	Seattle
H1969	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	REGENCE BLUESHIELD OF IDAHO	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1977	Automated TrOOP Balance Transfer Contact	Medicare Account Manager		Peczynski	Jody	S	1-248-341-8158	68158				jspeczynski@magellanhealth.com	Magellan Rx	2520 Industria Row Drive	Troy	MI	48084	03/22/2021	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Best Available Evidence Contact	Government Programs Manager	Ms.	Stewart	Nicole		1-906-232-1601				1-906-232-1604	nstewart@uphp.com	853 W. Washington Street		Marquette	MI	49855	09/15/2021	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Chief Financial Officer	Chief Financial Officer	Ms.	Houghton	Jaime		1-906-225-7491				1-906-225-8687	jhoughton@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/07/2021	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	CMS Casework Communication Contact	Government Programs Manager	Ms.	Stewart	Nicole		1-906-232-1601				1-906-232-1604	nstewart@uphp.com	853 W. Washington Street		Marquette	MI	49855	09/15/2021	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Coordination of Benefits Contact	Director of Claims Administration	Ms.	LaCosse	Leslie		1-906-225-7503					llacosse@uphp.com	853 W. Washington Street		Marquette	MI	49855	07/20/2020	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Customer Service Operations Contact	Chief Operating Officer	Ms.	Bicigo	Melanie		1-906-225-7749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	07/20/2020	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Government Relations Contact	Chief Operating Officer	Ms.	Bicigo	Melanie		1-906-225-7749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	07/20/2020	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Hospice Contact	Clinical Services Manager		Sandstrom	Nicole		1-906-225-7784					nsandstrom@uphp.com	853 W. Washington Street		Marquette	MI	49855	02/02/2018	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Medicare Compliance Officer	Compliance & Risk Management Officer	Ms.	Sandstrom	Nicole		1-906-225-7784				1-906-225-8684	nsandstrom@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/22/2022	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Part D Exceptions Contact	Director of Pharmacy	Ms.	Prusi	Rachael	Y					1-906-225-4516	rprusi@uphp.com	853 W. Washington Street		Marquette	MI	49855	03/22/2021	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active	1-877-349-9324				Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Pharmacy Network Management Contact	Director of Pharmacy	Ms.	Prusi	Rachael	Y	1-906-225-7876				1-906-225-4516	rprusi@uphp.com	853 W. Washington Street		Marquette	MI	49855	03/22/2021	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Pharmacy Technical Help Desk Contact	Sr Manager, CDAG, Medicare Part D		DiBiase	Joe							jdibiase@magellanhealth.com	Magellan Rx	PO Box 2187	Maryland Heights	MO	63043	12/16/2022	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active	1-855-380-0275				Demo Risk Option C	MMP HMO Demo	C	Chicago
H1977	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Houghton	Jaime		1-906-225-7491				1-906-225-8687	jhoughton@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/08/2021	2023	UPPER PENINSULA HEALTH PLAN, LLC	Demo	Upper Peninsula Health Plan (UPHP) MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		DLP Marquette General Hospital, LLC	416	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H1980	Automated TrOOP Balance Transfer Contact			Fowler	Elizabeth	D	1-859-296-6810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	09/24/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	Best Available Evidence Contact			West	Turner		1-859-276-5344					twest@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	09/22/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	Chief Financial Officer	CFO	Mrs.	Hodge	Holly		1-859-276-5344					hhodge@bgcarenav.org	1733 Harrisburg Rd.		Lexington	KY	40504	09/06/2022	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	CMS Casework Communication Contact			Fowler	Elizabeth	D	1-859-296-6810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	09/24/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	Coordination of Benefits Contact	CFO	Mrs.	Hodge	Holly		1-859-276-5344					hhodge@bgcarenav.org	1733 Harrisburg Rd.		Lexington	KY	40504	09/06/2022	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	Customer Service Operations Contact		Mrs.	Greene	Stephanie		1-859-276-5344					sgreene@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	08/30/2022	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	Government Relations Contact			West	Turner		1-859-276-5344					twest@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	09/23/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	Medicare Compliance Officer		Ms.	Smither	Eugenia		1-859-276-5344					esmither@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/23/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	Part D Exceptions Contact			Smither	Eugenia							esmither@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/23/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active	1-859-276-5344				PACE - Nat		C	Atlanta
H1980	Pharmacy Network Management Contact			Kelley	Debra		1-859-276-5344					dkelley@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/23/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1980	Pharmacy Technical Help Desk Contact			Smither	Eugenia							esmither@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/23/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active	1-859-276-5344				PACE - Nat		C	Atlanta
H1980	Plan to Plan Reconciliation Contact			Fowler	Elizabeth	D	1-859-296-6810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	09/24/2020	2023	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active					PACE - Nat		C	Atlanta
H1993	Automated TrOOP Balance Transfer Contact	Controller	Mr.	Tran	Son		1-714-766-9099				1-949-393-8879	son.tran@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	02/16/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Best Available Evidence Contact	General Counsel/Compliance Officer	Mr	Song	Paul	J	1-626-260-7366					paul.song@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	09/21/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Chief Financial Officer	Chief Financial Officer	Ms.	Luong	Chi		1-858-229-3755				1-949-393-8879	chi.luong@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	02/15/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	CMS Casework Communication Contact	General Counsel/Compliance Officer	Mr.	Song	Paul	J	1-626-260-7366				1-949-393-8879	paul.song@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	09/21/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Coordination of Benefits Contact	General Counsel/Compliance Officer	Mr.	Song	Paul	J	1-626-260-7366				1-949-393-8879	paul.song@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	09/21/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Customer Service Operations Contact	Sr. Manager, Enrollment & Member Services	Ms.	Dao	Kery		1-949-522-9170				1-949-393-8879	kery.dao@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	02/16/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Government Relations Contact	General Counsel/Compliance Officer	Mr.	Song	Paul	J	1-626-260-7366					paul.song@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	09/21/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Hospice Contact	Chief Medical Officer	Dr.	Trinh	Dung		1-714-334-8739				1-949-393-8879	dung.trinh@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	02/16/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Medicare Compliance Officer	General Counsel/Compliance Officer	Mr	Song	Paul	J	1-626-260-7366					paul.song@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	09/21/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Part D Exceptions Contact	Associate Vice President of Clinical Operations		Lavignette	Amanda							alavignette@elixirsolutions.com	2181 East Aurora Road, Suite 201		Twinsburg	OH	44087	11/18/2020	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	San Francisco
H1993	Pharmacy Network Management Contact	Director Pharmacy Network Contracting		Dyer	Tim		1-330-888-4812					Tdyer@envisionrx.com	2181 East Aurora Road, Suite 201		Twinsburg	OH	44087	02/11/2020	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1993	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							wtafoya@envisionrx.com	2181 East Aurora Road, Suite 201		Twinsburg	OH	44087	01/26/2021	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active	1-833-697-6561				HMO - Health Maintenance Organization		C	San Francisco
H1993	Plan to Plan Reconciliation Contact	Controller	Mr.	Tran	Son		1-714-766-9099				1-949-393-8879	son.tran@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	02/16/2022	2023	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Group, LLC	748	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H1994	Automated TrOOP Balance Transfer Contact		Mr.	Williams	Steven		1-801-442-7801					steven.l.williams@selecthealth.org	5381 S Green St		Murray	UT	84123	09/11/2012	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Best Available Evidence Contact	Medicare Enrollment Supervisor	Ms.	Baer	Mallory		1-801-442-9842					mallory.baer@selecthealth.org	5381 S Green St		Murray	UT	84123	09/20/2021	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Chief Financial Officer	Chief Financial Officer	Mr.	Trettin	Todd		1-801-442-7760					todd.trettin@selecthealth.org	5381 S. Green Street		Murray	UT	84123	01/25/2021	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	CMS Casework Communication Contact	Appeals and Grievances Director	Ms.	Johnson	Emily		1-801-442-7650					emily.johnson@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Coordination of Benefits Contact	ORBT Supervisor	Ms.	Aagard	Amanda		1-801-442-7006					Rxcob@imail.org	5381 S Green St		Murray	UT	84123	04/29/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Customer Service Operations Contact	Operations Manager	Mr.	Richins	JJ		1-801-442-8173					jj.richins@selecthealth.org	5381 S Green St		Murray	UT	84123	05/10/2016	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Government Relations Contact	VP and Chief Administrative Officer	Ms.	McCullagh	Kristin		1-801-442-3436					kristin.mccullagh@selecthealth.org	5381 S Green St		Murray	UT	84123	04/29/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Hospice Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		1-801-442-7797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Schmidt	Cliff		1-801-442-7249					clifton.schmidt@selecthealth.org	5381 S Green St		Murray	UT	84123	10/27/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Exceptions Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike							mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active	1-855-442-9900				HMO - Health Maintenance Organization		C	Dallas
H1994	Pharmacy Network Management Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		1-801-442-7797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Pharmacy Technical Help Desk Contact	Pharmacy Operations Supervisor	Ms.	Rueckert	Stacey							stacey.rueckert@selecthealth.org	5381 S Green St		Murray	UT	84123	02/28/2017	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active	1-855-442-9900				HMO - Health Maintenance Organization		C	Dallas
H1994	Plan to Plan Reconciliation Contact	Accounting Supervisor	Mr.	Applegarth	John		1-801-442-7980					john.applegarth@selecthealth.org	5381 S Green St		Murray	UT	84123	11/20/2012	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1997	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				HMO - Health Maintenance Organization		C	Seattle
H1997	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1997	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				HMO - Health Maintenance Organization		C	Seattle
H1997	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2001	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H2001	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2001	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H2001	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/22/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2029	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H2029	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H2029	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2032	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Bush	Stephen		1-254-298-3568				1-254-298-3005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Best Available Evidence Contact	Director HP Enrollment		Wilson	Deanna		1-254-298-3340					Deanna.Wilson@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/24/2022	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Chief Financial Officer	Chief Financial Officer	Mr.	Bush	Stephen	P	1-254-298-3568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/20/2017	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	CMS Casework Communication Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/06/2020	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Coordination of Benefits Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/06/2020	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Customer Service Operations Contact	Manager, Customer Advocacy		Perkins	Michelle		1-254-298-3393					Michelle.Perkins@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Government Relations Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/06/2020	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Hospice Contact	Director Pharmacy Operations		Luebbert	Charlotte		1-254-298-6151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/09/2018	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Medicare Compliance Officer	Compliance Officer	Mrs	Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/06/2020	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Part D Exceptions Contact	Manager Pharmacy Admin.		Thomas	Megan							Megan.Cunningham@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/15/2019	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active	1-254-298-6108				PPO - BBA		C	Dallas
H2032	Pharmacy Network Management Contact	Director Pharmacy Operations		Luebbert	Charlotte		1-254-298-6151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/09/2018	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2032	Pharmacy Technical Help Desk Contact	OptumRx		Rx	Optum								1600 McConnor Parkway		Schaumburg	IL	60173-6801	03/14/2019	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active	1-844-230-9357				PPO - BBA		C	Dallas
H2032	Plan to Plan Reconciliation Contact	Chief Financial Officer		Bush	Stephen		1-254-298-3568				1-254-298-3005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Holdings	588	Yes	Active					PPO - BBA		C	Dallas
H2034	Automated TrOOP Balance Transfer Contact	Director of Operations	Mrs.	Slowiak	Andrea		1-715-852-2983					aslowiak@pharmastar.com	2427 Hillcrest Parkway		Altoona	WI	54720	02/19/2021	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Best Available Evidence Contact	Accounting Specialist - Medicare	Ms.	Instefjord	Lori		1-262-207-9374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Chief Financial Officer	Chief Financial Officer	Ms.	Smith	Christy		1-414-231-4000					christy.smith@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/25/2017	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	CMS Casework Communication Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		1-262-207-9307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Coordination of Benefits Contact	Claims Manager	Ms	Halloran	Colleen		1-262-953-8627					colleen.halloran@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	04/12/2016	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Customer Service Operations Contact	CCHP Program Officer	Ms.	Carter	Kelly		1-262-207-9323					kelly.carter@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	11/13/2020	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Government Relations Contact	Chief Executive Officer	Mr	Munson	Kenneth		1-262-207-9339					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	03/23/2015	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Hospice Contact	Clinical  and Plan Services Pharmacy Manager	Mr.	Mayer	Dmitri		1-414-231-4107					dmitri.mayer@communitycareinc.org	3220 W. Vliet		Milwaukee	WI	53208	06/22/2021	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Medicare Compliance Officer	Chief Compliance and Quality Officer	Mr.	Garlie	Michael		1-262-207-9307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	03/10/2020	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Part D Exceptions Contact	Clinical  and Plan Services Pharmacy Manager	Mr.	Mayer	Dmitri							dmitri.mayer@communitycareinc.org	3222 W. Vliet		Milwaukee	WI	53208	06/22/2021	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active	1-866-992-6600	14107			HMO - Health Maintenance Organization		C	Chicago
H2034	Pharmacy Network Management Contact	Clinical  and Plan Services Pharmacy Manager	Mr.	Mayer	Dmitri		1-414-231-4107					dmitri.mayer@communitycareinc.org	3220 W. Vliet		Milwaukee	WI	53208	06/22/2021	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Pharmacy Technical Help Desk Contact			Service	Customer								2503 N. Hillcrest Pkwy		Altoona	WI	54720	03/16/2007	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active	1-888-298-7770				HMO - Health Maintenance Organization		C	Chicago
H2034	Plan to Plan Reconciliation Contact	Accounting Specialist - Medicare	Ms	Instefjord	Lori		1-262-207-9374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2023	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2056	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/06/2018	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/17/2020	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/22/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/22/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/22/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H2056	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/30/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2056	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H2056	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2064	Automated TrOOP Balance Transfer Contact	DIrector, LIFE Geisinger	Ms.	Kubasti	Teena		1-570-214-9790				1-570-214-9791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	17822-7801	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Best Available Evidence Contact	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	1-570-214-9806				1-570-214-9791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	17822-6065	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Chief Financial Officer	Director, Financial Reporting	Ms.	Pusti	Jessica		1-570-582-5447					jmpusti1@geisinger.edu	100 North Academy Avenue	MC 30-69	Danville	PA	17822-3069	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	CMS Casework Communication Contact	Quality & Special Projects Coordinator	Ms.	Coolbaugh	Brenna		1-570-846-2911				1-570-808-8949	bcoolbaugh1@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	17822-7801	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Coordination of Benefits Contact	Director, LIFE Geisinger	Ms.	Kubasti	Teena	A	1-570-214-9790				1-570-214-9791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	17822-7801	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Customer Service Operations Contact	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	1-570-214-9806				1-570-214-9791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	17822-6065	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Government Relations Contact	Director, LIFE Geisinger	Ms.	Kubasti	Teena		1-570-214-9790				1-570-214-9791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	17822-7801	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Medicare Compliance Officer	Director, LIFE Geisinger	Ms.	Kubasti	Teena		1-570-214-9790				1-570-214-9791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	17822-7801	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Exceptions Contact	Director, LIFE Geisinger	Ms.	Kubasti	Teena						1-570-214-9791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	17822-7801	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active	1-800-395-8759				PACE - Nat		C	Philadelphia
H2064	Pharmacy Network Management Contact	Director. LIFE Geisinger	Ms.	Kubasti	Teena		1-570-214-9790				1-570-214-9791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	17822-7801	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Pharmacy Technical Help Desk Contact	Director, LIFE Geisinger	Ms.	Kubasti	Teena						1-570-214-9791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	17822-7801	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active	1-800-395-8759				PACE - Nat		C	Philadelphia
H2064	Plan to Plan Reconciliation Contact	Accountant Intermediate	Ms.	Manning	Emily		1-570-271-5555					ekmanning@geisinger.edu	100 North Academy Avenue		Danville	PA	17822	03/11/2022	2023	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Geisinger Health	96	Yes	Active					PACE - Nat		C	Philadelphia
H2085	Automated TrOOP Balance Transfer Contact			Wachsmuth	Rosalie		1-503-215-3681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Best Available Evidence Contact			Wachsmuth	Rosalie		1-503-215-3681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Chief Financial Officer		Ms	Barr	Natalie		1-503-215-3859					natalie.barr@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	CMS Casework Communication Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		1-503-215-3681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Coordination of Benefits Contact	PACE Health Plan Data Analyst		Chambers	Perry		1-503-215-3672				1-503-215-0685	perry.chambers@providence.org	4515 Martin Luther King Jr. Way S. Ste. 100		Seattle	WA	98108	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Customer Service Operations Contact			Chinn	Velaa		1-206-320-5325					Velaa.Chinn@providence.org	4515 Martin Luther King Jr. Way S. Ste. 100		Seattle	WA	98108	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Government Relations Contact		Ms.	Noordijk	Cindy		1-503-215-4124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/12/2022	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Medicare Compliance Officer		Ms.	Noordijk	Cindy		1-503-215-4124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/21/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part D Exceptions Contact			Chambers	Perry							Perry.Chambers@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/21/2022	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active	1-503-215-3672				PACE - Nat		C	San Francisco
H2085	Pharmacy Network Management Contact			Schultz	Elizabeth		1-425-525-6908					Elizabeth.Schultz@providence.org	4515 Martin Luther King Jr Way S, Ste. 100		Seattle	WA	98108	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Pharmacy Technical Help Desk Contact			Schultz	Elizabeth							Elizabeth.Schultz@providence.org	4515 Martin Luther King Jr Way S, Ste. 100		Seattle	WA	98108	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active	1-425-525-6908				PACE - Nat		C	San Francisco
H2085	Plan to Plan Reconciliation Contact			Wachsmuth	Rosalie		1-503-215-3681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2023	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2108	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/20/2020	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H2108	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H2108	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2109	Automated TrOOP Balance Transfer Contact	Director	Mr.	Aistrop	Jonathan		1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	09/20/2018	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	Best Available Evidence Contact	Director	Mr.	Aistrop	Jonathan		1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	09/20/2018	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	Chief Financial Officer	Chief Financial Officer	Mr.	Larson	Mike		1-443-997-5710				1-443-997-5711	mlarson@jhmi.edu	3910 Keswick Rd Ste S4300A Rm S4200		Baltimore	MD	21211	03/13/2019	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	CMS Casework Communication Contact	Director	Mr.	Aistrop	Jonathan		1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/31/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	Coordination of Benefits Contact	Director	Mr.	Aistrop	Jonathan		1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/31/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	Customer Service Operations Contact	Director	Mr.	Aistrop	Jonathan		1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/31/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	Government Relations Contact	Director	Mr.	Aistrop	Jonathan		1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/31/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	Medicare Compliance Officer	Director, Hopkins ElderPlus	Mr.	Aistrop	Jonathan	H	1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	06/17/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	Part D Exceptions Contact	Director	Mr.	Aistrop	Jonathan						1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/31/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active	1-410-550-7044				PACE - Nat		C	Philadelphia
H2109	Pharmacy Network Management Contact	Director	Mr.	Aistrop	Jonathan		1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/31/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2109	Pharmacy Technical Help Desk Contact	Director	Mr.	Aistrop	Jonathan						1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/31/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active	1-410-550-7044				PACE - Nat		C	Philadelphia
H2109	Plan to Plan Reconciliation Contact	Director	Mr.	Aistrop	Jonathan		1-410-550-7044				1-410-550-7045	jaistro1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/31/2013	2023	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active					PACE - Nat		C	Philadelphia
H2117	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H2117	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2117	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H2117	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/05/2021	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H2128	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2128	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H2128	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/05/2021	2023	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2134	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H2134	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2134	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H2134	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H2162	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2162	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H2162	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2168	Automated TrOOP Balance Transfer Contact		Mr.	Esp	Bryan		1-858-790-6445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/03/2016	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Best Available Evidence Contact	VP, Member Experience and Support Services		Fernandez	Vanessa		1-212-337-5678					VanessaF@villagecare.org	120 Broadway		New York	NY	10271	02/01/2018	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Chief Financial Officer	Chief Financial Officer	Ms.	Tirado	Debra		1-212-337-5710					DebraT@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	12/28/2022	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	CMS Casework Communication Contact	AVP of Medicare, Medicaid & Regulatory Affairs	Miss	Platt	Keneisha		1-212-337-5641					KeneishaP@villagecare.org	112 Charles Street		New York	NY	10014	01/13/2021	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Coordination of Benefits Contact	AVP of Medicare, Medicaid & Regulatory Affairs	Miss	Platt	Keneisha		1-212-337-5641					KeneishaP@villagecare.org	112 Charles Street		New York	NY	10014	01/13/2021	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Customer Service Operations Contact	VP of Member Experience	Ms.	Fernandez	Vanessa		1-212-337-5678					vanessaf@villagecare.org	112 Charles Street		New York	NY	10014	11/15/2017	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Government Relations Contact	AVP of Medicare Regulatory Affairs	Miss	Wright	Sabrina		1-212-337-5884					SabrinaW2@villagecare.org	120 Broadway		New York	NY	10271	10/26/2021	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Hospice Contact	Pharmacy Specialist		Eng-Liu	Eileen		1-212-337-5600	5964				EileenE@villagecare.org	120 Broadway		New York	NY	10271	01/13/2021	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Medicare Compliance Officer	AVP of Medicare Regulatory Compliance	Miss	Wright	Sabrina		1-212-337-5884					sabrinaw2@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	10/21/2021	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Part D Exceptions Contact	Director, Medicare	Ms.	Platt	Keneisha							keneishap@villagecare.org	112 Charles Street		New York	NY	10014	02/01/2018	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active	1-212-337-5641				HMO - Health Maintenance Organization		C	New York
H2168	Pharmacy Network Management Contact			Maldonado	Cheryl		1-858-790-6397					cheryl.maldonado@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/03/2016	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2168	Pharmacy Technical Help Desk Contact			Battle	Dorry							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/03/2016	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active	1-888-807-6806				HMO - Health Maintenance Organization		C	New York
H2168	Plan to Plan Reconciliation Contact	Chief Financial Officer		Tirado	Debra		1-212-337-5710					DebraT@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	06/19/2019	2023	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2171	Automated TrOOP Balance Transfer Contact	Account Manager	Mr.	Battaglia	James		1-330-888-6165				1-330-888-6015	jbattaglia@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Best Available Evidence Contact	Director, Pharmacy	Ms.	May	Amy		1-817-632-2128				1-817-810-5214	Amy.may@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	10/21/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Chief Financial Officer	Chief Financial Officer	Mr	Birch	Harvey		1-817-632-3023					harvey.birch@southwesternhealth.org	1601 LBJ FWY	Suite 200	Farmers Branch	TX	75234	01/03/2023	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	CMS Casework Communication Contact	Manager Compliance Operations	Ms.	Atchison	Patricia		1-305-987-4917				1-817-810-5214	Patricia.Atchison@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	10/21/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Coordination of Benefits Contact	Sr Director, Strategic Operations	Mr.	Smith	Charles		1-817-632-3023				1-817-810-5214	charles.smith@southwesternhealth.org	1603 LBJ FWY	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Customer Service Operations Contact	Sr Director, Operations	Mr.	Greene	Shane		1-817-687-4066				1-817-687-4103	Shane.greene@cnchealthplan.com	1603 Lyndon B. Johnson	Suite 300	Farmers Branch	TX	75234	10/21/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Government Relations Contact	Compliance Officer	Ms.	Scott	Elizabeth		1-850-549-5430					elizabeth.scott@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	10/21/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Hospice Contact	Clinical Pharmacy Services	Ms.	May  Pharm D	Amy		1-817-632-2128				1-817-810-5214	amy.may@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	10/21/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Medicare Compliance Officer	Compliance Officer	Ms.	Scott	Elizabeth		1-850-549-5430					elizabeth.scott@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	10/21/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Part D Exceptions Contact	Director, Pharmacy Services	Ms.	May	Amy							amy.may@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	10/21/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active	1-817-632-2128				HMO - Health Maintenance Organization		C	Dallas
H2171	Pharmacy Network Management Contact	Director Pharmacy Network Development	Ms.	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2171	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active	1-855-791-5302				HMO - Health Maintenance Organization		C	Dallas
H2171	Plan to Plan Reconciliation Contact	Controller	Mr.	Aliyev	Elshan		1-832-282-3322					elshan.aliyev@southwesternhealth.org	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	10/21/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	HMO/HMOPOS		Texas Health Resources	709	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2172	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	1-562-367-0592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Chief Financial Officer	Vice President & Chief Financial Officer	Ms.	Shepler	Courtney	R	1-510-271-4644					courtney.r.shepler@kp.org	National Medicare Finance, 1 Kaiser Plaza, 13th Floor	c/o Kaiser Foundation Health Plan,	Oakland	CA	94612	05/17/2017	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	CMS Casework Communication Contact	Medicare Contract Compliance Manager		McLean	Pamela		1-301-816-5737				1-301-816-7275	pamela.l.mclean@kp.org	2101 East Jefferson Street		Rockville	MD	20852	01/12/2017	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Coordination of Benefits Contact	Senior Director		Chung	Clarence		1-562-390-9293				1-562-658-3866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Customer Service Operations Contact	Sr Director Member Relations		Devers	Jason	C	1-323-302-7947				1-404-949-5001	jason.c.devers@kp.org	Nine Piedmont Center	3495 Piedmont Road, NE	Atlanta	GA	30305	01/10/2022	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	1-510-271-6835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	01/12/2017	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Medicare Compliance Officer	Medicare Contract Compliance Manager	Ms	McLean	Pamela		1-240-330-8451				1-301-816-7275	pamela.l.mclean@kp.org	2101 East Jefferson Street		Rockville	MD	20852	05/03/2022	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Part D Exceptions Contact	Pharmacy Benefits Manager		Hoard	Shannon						1-703-466-4802	shannon.m.hoard@kp.org	22370 Davis Drive	Suite 190	Sterling	VA	20164	08/02/2022	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-888-777-5536				HMO - Health Maintenance Organization		C	San Francisco
H2172	Pharmacy Network Management Contact	Pharmacy Benefits Manager		Hoard	Shannon		1-703-673-8660				1-703-466-4802	shannon.m.hoard@kp.org	22370 Davis Drive	Suite 190	Sterling	VA	20164	08/02/2022	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2172	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	01/12/2017	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-888-791-7229				HMO - Health Maintenance Organization		C	San Francisco
H2172	Plan to Plan Reconciliation Contact	Director, National Medicare & Medicaid Finance		Callender	Margaret		1-510-433-6709					margaret.callender@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	10/25/2017	2023	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2174	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H2174	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2174	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H2174	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare by Trillium	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2185	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/18/2021	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	08/12/2019	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	08/12/2019	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		1-615-481-1897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	08/10/2022	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Part D Exceptions Contact	Sr. Manager, Clinical Prior Authorization		LeClair	Christophe						1-920-221-4676	Christopher.LeClair@Navitus.com	1025 West Navitus Drive		Madison	WI	54913	03/18/2021	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Philadelphia
H2185	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/15/2021	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2185	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/18/2021	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Philadelphia
H2185	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	LIFEWORKS ADVANTAGE, LLC	Local CCP	LifeWorks Advantage	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2196	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H2196	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2196	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H2196	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/21/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2218	Automated TrOOP Balance Transfer Contact	Director of Finance	Ms	O'Sullivan	Maureen		1-617-533-2400	3428			1-617-533-2401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	Best Available Evidence Contact	Executive Director	Ms.	Reynard	Gretchen		1-617-533-2424	2424			1-617-533-2401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	Chief Financial Officer	CFO	Mr.	Murphy	Todd		1-617-533-2300	2333				tmurphy@hhsi.us	1135 Morton Street		Mattapan	MA	02126	12/05/2017	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	CMS Casework Communication Contact	Executive Director	Ms.	Reynard	Gretchen		1-617-533-2424	2424			1-617-533-2401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	Coordination of Benefits Contact	Director of Finance	Ms.	O'Sullivan	Maureen		1-617-533-2400	2426			1-617-533-2401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	Customer Service Operations Contact	Clinical Director		McMahon	Mardi		1-617-533-2400				1-617-533-2401	mmcmahon@hhsi.us	1135 Morton Street		Mattapan	MA	02126	04/23/2010	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	Government Relations Contact	Executive Director	Ms.	Reynard	Gretchen		1-617-533-2424	2424			1-617-533-2401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	Medicare Compliance Officer	Director of Quality and Compliance	Ms.	Azar	Pamela		1-774-470-6700	6740			1-617-533-2484	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	09/30/2020	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	Part D Exceptions Contact	Pharmacist		Bouwmeester	Carla						1-617-533-2401	cbouwmeester@hhsi.us	1135 Morton Street		Mattapan	MA	02126	04/23/2010	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active	1-866-714-1277				PACE - Nat		C	Boston
H2218	Pharmacy Network Management Contact	Executive Director	Ms.	Reynard	Gretchen		1-617-533-2424	2424			1-617-533-2401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2218	Pharmacy Technical Help Desk Contact	Pharmacist		Bouwmeester	Carla						1-617-533-2401	cbouwmeester@hhsi.us	1135 Morton Street		Mattapan	MA	02126	04/23/2010	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active	1-866-714-1277				PACE - Nat		C	Boston
H2218	Plan to Plan Reconciliation Contact	Director of Finance		O'Sullivan	Maureen		1-617-533-2400				1-617-533-2401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2023	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active					PACE - Nat		C	Boston
H2219	Automated TrOOP Balance Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		1-800-333-2535	79089				Christina.Farrar@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/24/2019	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	Best Available Evidence Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		1-800-333-2535	79089				Christina.Farrar@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/24/2019	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	Chief Financial Officer	Chief Financial Officer	Mr.	Bailey	Todd		1-508-368-9097				1-508-791-4332	Todd.Bailey@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	08/27/2019	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	CMS Casework Communication Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		1-508-799-2100	79275				Heather.Ulfves@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	09/10/2020	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	Coordination of Benefits Contact	Senior Director, Claims Administration	Ms	Straitiff	Kirsten		1-508-368-9047					kirsten.straitiff@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	09/20/2022	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	Customer Service Operations Contact	VP, Customer Service	Mr.	Perron	Donald		1-508-368-9701					Donald.Perron@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	12/01/2015	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	Government Relations Contact	Government Affairs and Public Policy Director	Ms.	Bik	Christie		1-508-368-9523					Christie.Bik@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	09/10/2020	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	Medicare Compliance Officer	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		1-508-368-9539					Lisa.Lashbrook@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	12/01/2015	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	Part D Exceptions Contact	Manager, Pharmacy Ops & Clinical Programs	Mr.	Sartini	David							David.Sartini@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	12/04/2018	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	1-508-368-9790				PACE - Nat		C	Boston
H2219	Pharmacy Network Management Contact	VP, Pharmacy Services	Mr.	Barner	Benjamin		1-508-368-9660					Benjamin.Barner@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608-2810	09/19/2022	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2219	Pharmacy Technical Help Desk Contact			Help Desk	OptumRx								1600 McConnor Parkway		Schaumburg	IL	60173	12/29/2021	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	1-844-368-8734				PACE - Nat		C	Boston
H2219	Plan to Plan Reconciliation Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		1-508-368-9085					Shawn.McNamara@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	12/01/2015	2023	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	Boston
H2220	Automated TrOOP Balance Transfer Contact	Insurance Coordinator		Wong	Kowk		1-617-288-0970				1-617-474-0757	kwwong@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	Best Available Evidence Contact	Chief PACE Program Officer		Roach	Nancy	J	1-617-288-0970	8803			1-617-474-0757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	Chief Financial Officer	CFO	Mr.	Cherry	Kevin		1-617-287-8000	8711				Kecherry@uphams.org	500 Columbia Road		Dorchester	MA	02125	05/19/2021	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	CMS Casework Communication Contact	Chief PACE Program Officer		Roach	Nancy	J	1-617-288-0970	8803			1-617-474-0757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	Coordination of Benefits Contact	Chief PACE Program Officer		Roach	Nancy	J	1-617-288-0970	8803			1-617-474-0757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	Customer Service Operations Contact	Chief PACE Program Officer		Roach	Nancy	J	1-617-288-0970	8803			1-617-474-0757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/24/2022	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	Government Relations Contact	CEO	Mr.	Trivedi	Jagdeep		1-617-740-8131				1-617-282-8625	jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	12/09/2015	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	Medicare Compliance Officer	Compliance Officer	Mrs.	Mitza	Kerry		1-617-287-8000	8030			1-617-282-8625	kmitza@uphams.org	415 Columbia Road		Dorchester	MA	02125	09/12/2016	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	Part D Exceptions Contact	Chief PACE Program Officer		Roach	Nancy						1-617-474-0757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active	1-617-288-0970				PACE - Nat		C	Boston
H2220	Pharmacy Network Management Contact	Medical Director		Burrows	Adam		1-617-440-1615	8901			1-617-442-2589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	11/30/2013	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2220	Pharmacy Technical Help Desk Contact	Chief PACE Program Officer		Roach	Nancy						1-617-474-0757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/24/2022	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active	1-617-288-0970				PACE - Nat		C	Boston
H2220	Plan to Plan Reconciliation Contact	Insurance Coordinator		Wong	Kowk		1-617-288-0970				1-617-474-0757	kwwong@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2023	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Uphams Corner Health Committee, Inc.	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	Boston
H2221	Automated TrOOP Balance Transfer Contact	Finance Manager	M	Mclellan	Scott		1-617-575-5850				1-617-499-8360	samclellan@challiance.org	163 Gore Street		Cambridge	MA	02141	11/06/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	Best Available Evidence Contact	Quality and Compliance Manager	M	Tylander	Kathryn		1-617-575-5850					ktylander@challiance.org	163 Gore St		Cambridge	MA	02141	09/03/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	Chief Financial Officer	Finance Manager	M	Mclellan	Scott		1-617-575-5850				1-617-499-8360	samclellan@challiance.org	163 Gore Street		Cambridge	MA	02141	11/06/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	CMS Casework Communication Contact	Operations Director	M	Donnelly	Sue		1-617-575-5850					sdonnelly@challiance.org	163 Gore St		Cambridge	MA	02141	08/25/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	Coordination of Benefits Contact	Finance Manager	M	Mclellan	Scott		1-617-575-5850				1-617-499-8360	samclellan@challiance.org	163 Gore Street		Cambridge	MA	02141	11/06/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	Customer Service Operations Contact	Operations Director	M	Donnelly	Sue		1-617-575-5850					sdonnelly@challiance.org	163 Gore St		Cambridge	MA	02141	08/25/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	Government Relations Contact	Executive Director	Mr	Geyerhahn	Jed		1-617-575-5850					jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	04/27/2017	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	Medicare Compliance Officer	Quality and Compliance Manager	M	Tylander	Kathryn		1-617-499-8301					ktylander@challiance.org	163 Gore St		Cambridge	MA	02141	09/03/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	Part D Exceptions Contact	Finance Manager		Mclellan	Scott						1-617-499-8360	samclellan@challiance.org	163 Gore Street		Cambridge	MA	02141	11/06/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active	1-617-575-5850				PACE - Nat		C	Boston
H2221	Pharmacy Network Management Contact	Pharmacist	Ms.	Emma	D'Alleva		1-617-575-5850					edalleva@challiance.org	163 Gore St		Cambridge	MA	02141	11/06/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2221	Pharmacy Technical Help Desk Contact	Pharmacist		Emma	D'Alleva							edalleva@challiance.org	163 Gore St		Cambridge	MA	02141	11/06/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active	1-617-575-5850				PACE - Nat		C	Boston
H2221	Plan to Plan Reconciliation Contact	Finance Manager		Mclellan	Scott		1-617-575-5850				1-617-499-8360	samclellan@challiance.org	163 Gore Street		Cambridge	MA	02141	11/06/2020	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	Boston
H2222	Automated TrOOP Balance Transfer Contact	EDI Systems Analyst		Caruso-Mahoney	Dee		1-781-715-6640				1-781-715-6698	dcaruso@elementcare.org	37 Friend Street		Lynn	MA	01901	11/03/2020	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	Best Available Evidence Contact	Director Claims Management		Pickens	Deb		1-781-715-6616				1-781-715-6698	dpickens@elementcare.org	37 Friend Street		Lynn	MA	01901	11/03/2020	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	Chief Financial Officer	CFO	MR	Durante	Robert	P	1-781-715-6620				1-781-715-6699	bdurante@elementcare.org	37 Friend Street		Lynn	MA	01901	06/30/2014	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	CMS Casework Communication Contact	CFO		Durante	Robert	P	1-781-715-6620				1-781-715-6699	bdurante@elementcare.org	37 Friend Street		Lynn	MA	01901	06/30/2014	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	Coordination of Benefits Contact	CFO		Durante	Robert	P	1-781-715-6620				1-781-715-6699	bdurante@elementcare.org	37 Friend Street		Lynn	MA	01901	06/30/2014	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	Customer Service Operations Contact	Customer Service		Recinos	Carla		1-781-715-6612				1-781-715-6699	crecinos@elementcare.org	37 Friend Street		Lynn	MA	01901	01/29/2018	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	Government Relations Contact	COO	Mrs	Dugan	Mary Ellen		1-781-715-6617				1-781-715-6699	mdugan@elementcare.org	37 Friend Street		Lynn	MA	01901	06/30/2014	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	Medicare Compliance Officer	Director Compliance	Ms	Schneid	Jennifer		1-630-200-9658				1-781-715-6699	jschneid@elementcare.org	37 Friend Street		Lynn	MA	01902	01/21/2016	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	Part D Exceptions Contact	CFO		Durante	Robert	P					1-781-715-6699	bdurante@elementcare.org	37 Friend Street		Lynn	MA	01901	06/30/2014	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active	1-781-715-6620				PACE - Nat		C	Boston
H2222	Pharmacy Network Management Contact	Consultant Pharmacy Network		Dennison	Martha		1-781-934-2936					mdennison@elementcare.org	37 Friend Street		Lynn	MA	01902	10/03/2019	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2222	Pharmacy Technical Help Desk Contact	Consultant Pharmacy Network		Dennison	Martha							mdennison@elementcare.org	37 Friend Street		Lynn	MA	01902	10/03/2019	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active	1-781-715-6608				PACE - Nat		C	Boston
H2222	Plan to Plan Reconciliation Contact	CFO		Durante	Robert	P	1-781-715-6620				1-781-715-6699	bdurante@elementcare.org	37 Friend Street		Lynn	MA	01901	06/30/2014	2023	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	Boston
H2223	Automated TrOOP Balance Transfer Contact	Senior Health Plan Analyst		Diaz	Michael		1-781-307-2697					diazmi@ebnhc.org	10 Gove Street		East Boston	MA	02128	11/02/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	Best Available Evidence Contact	Medical Director	Dr.	Pedulla	James		1-617-569-6800				1-617-568-7259	pedullaj@ebnhc.org	10 Gove Street		East Boston	MA	02128	05/20/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	Chief Financial Officer	CFO	Mr.	Hazard	James		1-617-569-5800					hazardj@ebnhc.org	10 Gove St		East Boston	MA	02128	05/23/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	CMS Casework Communication Contact	VP		Ip	Calay		1-617-568-4570					ipc@ebnhc.org	10 Gove St		East Boston	MA	02128	11/28/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	Coordination of Benefits Contact	Senior Health Plan Analyst		Diaz	Michael		1-781-307-2697					diazmi@ebnhc.org	10 Gove Street		East Boston	MA	02128	11/04/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	Customer Service Operations Contact	VP		Ip	Calay		1-617-568-4714					ipc@ebnhc.org	10 Gove St		East Boston	MA	02128	11/28/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	Government Relations Contact	VP		Ip	Calay		1-617-568-4714					ipc@ebnhc.org	10 Gove St		East Boston	MA	02128	11/22/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	Medicare Compliance Officer	General Counsel, Compliance Officer	Mr.	DeAraujo	Ernani		1-617-568-4714					dearujoe@ebnhc.org	10 Gove St		East Boston	MA	02128	05/20/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	Part D Exceptions Contact	Medical Director	Dr.	Pedulla	James							pedullaj@ebnhc.org	10 Gove St		East Boston	MA	02128	05/20/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active	1-617-568-4570				PACE - Nat		C	New York
H2223	Pharmacy Network Management Contact	Director, Health Plan Operations		Febles	Jacklyn		1-617-568-4732					feblesj@ebnhc.org	10 Gove Street		East Boston	MA	02128	05/23/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2223	Pharmacy Technical Help Desk Contact	Pharmacy Manager		Souza	Ashley							souzaa@ebnhc.org	10 Gove St		East Boston	MA	02128	05/23/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active	1-800-439-0183				PACE - Nat		C	New York
H2223	Plan to Plan Reconciliation Contact	Director, Health Plan Operations		Febles	Jacklyn		1-617-568-4732					feblesj@ebnhc.org	10 Gove Street		East Boston	MA	02128	05/23/2022	2023	East Boston Neighborhood Center Corp.	National PACE	Neighborhood PACE	National PACE		East Boston Neighborhood Center Corp.	84	Yes	Active					PACE - Nat		C	New York
H2224	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/14/2021	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H2224	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H2224	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	SENIOR WHOLE HEALTH, LLC	Local CCP	Senior Whole Health	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2225	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment and Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Best Available Evidence Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931				randrade@commonwealthcare.org	30 Winter St		Boston	MA	02108	02/05/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Chief Financial Officer	Chief Financial Officer	Ms.	Hamilton	Mary		1-857-327-1953					mahamilton@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	CMS Casework Communication Contact	Director, Appeals& Grievances		Schenk	Tyrone		1-857-327-3320				1-857-453-4517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Coordination of Benefits Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931			1-617-426-3109	randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/05/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Customer Service Operations Contact	VP, Customer Service		Habib	Fred		1-617-426-0600	1504			1-617-426-3097	fhabib@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/13/2019	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Government Relations Contact	VP, Government Relations		Preede	Ken		1-617-426-0600	51412				kpreede@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/30/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Hospice Contact	Palliative Care Medical Director		Ragland	Julia		1-781-525-4203					jragland@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	10/04/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	Lavallee	Katherine		1-617-947-5780					KLavalee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/01/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Exceptions Contact	Sr. Manager, Clinical Prior Auth		LeClair	Christophe						1-920-221-4676	Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/25/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877				HMO - Health Maintenance Organization		C	Boston
H2225	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@Navitus.com	361 Integrity Drive		Madison	WI	53713	03/25/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Pharmacy Technical Help Desk Contact	Sr. Mgr, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	53713	03/25/2021	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Boston
H2225	Plan to Plan Reconciliation Contact	Accounts Receivable Coordinator		Newman	Elaine		1-617-426-0600	52580				enewman@commonwealthcare.org	30 Winter St		Boston	MA	02108	08/25/2022	2023	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/17/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	Boston
H2226	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	Boston
H2226	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/22/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2228	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H2228	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2228	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/22/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H2228	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/22/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2230	Automated TrOOP Balance Transfer Contact	Reporting Sr. Analyst		Kovalski	Robin		1-617-246-8586				1-617-246-8506	Robin.Kovalski@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	02043-4359	08/04/2021	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Best Available Evidence Contact	Supervisor		Brown	Janice		1-617-246-8513				1-617-246-8506	janice.brown@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	02043-4359	04/12/2012	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Chief Financial Officer	Chief Financial Officer	Ms.	Santangelo	Andreana		1-617-246-3600					Andreana.Santangelo@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	02199-7611	12/19/2016	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	CMS Casework Communication Contact	Appeals and Grievance Manager		Ronaghan	Danielle		1-617-246-4663				1-617-246-8506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place	Mailstop 03-04	Hingham	MA	02043-4359	12/15/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Coordination of Benefits Contact	Specialist II Business Ops		Seesholtz	Janet		1-617-246-9587					Janet.Seesholtz@bcbsma.com	One Enterprise Drive		Quincy	MA	02171	05/26/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Customer Service Operations Contact	Member Service Director		Hanstein	deMarigny		1-617-246-8941					deMarigny.Hanstein@bcbsma.com	P. O. Box 55007		Boston	MA	02205-5007	11/18/2019	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Government Relations Contact	Senior Director of Federal and National Affairs		Savage	Deirdre		1-617-246-3359					deirdre.savage@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	02199-7611	06/09/2015	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Hospice Contact	Clinical Pharmacy Manager		Wong	Timothy		1-617-246-6927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	03/29/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Sullivan	Christina		1-781-603-8012					MAPDCompliance@bcbsma.com	25 Technology Place	Mail stop 03/03	Hingham	MA	02043-4359	04/28/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Part D Exceptions Contact	Director, Pharmacy Operations		Nelhuebel	Melinda						1-866-463-7700	Melinda.Nelhuebel@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/29/2018	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active	1-800-366-7778				PPO - BBA		C	Boston
H2230	Pharmacy Network Management Contact	Lead Director, Network Management		Smith	Shawn		1-480-391-4844					Shawn.Smith@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	12/27/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2230	Pharmacy Technical Help Desk Contact	Director, Client Operations		Dayoub	Joselyn							Dayoubj@CVSHealth.com	CVS Health 800 NW Chipman RD	Ste 5830	Lees Summit	MO	64063	12/27/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active	1-866-693-4620				PPO - BBA		C	Boston
H2230	Plan to Plan Reconciliation Contact	Director, Corporate Accounting and Reporting		Thurber	Steven		1-617-246-6523				1-617-246-7806	Steven.Thurber@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	02199-7611	12/04/2017	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	Local PPO		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					PPO - BBA		C	Boston
H2235	Automated TrOOP Balance Transfer Contact	Director, Enrollment	Mr.	Wade	Greg		1-314-209-2810					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/05/2018	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Best Available Evidence Contact	Director, Enrollment	Mr.	Wade	Greg		1-314-209-2810					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/05/2018	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Chief Financial Officer	Chief Financial Officer	Mr.	Rood	David		1-727-519-1208					David.Rood@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/01/2022	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		1-727-519-1974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Coordination of Benefits Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	05/21/2021	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Customer Service Operations Contact	Vice President, Customer Service	Ms.	Meyerhoeffer	Linda		1-636-686-9682					rmeyerhoeffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2019	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Government Relations Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		1-727-519-1974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Hospice Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					pharmacy@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/05/2018	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Tofani	Joanna		1-727-519-1974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Part D Exceptions Contact	Dir PA Clinical Programs	Mr.	McGurran	Shawn							Shawn.McGurran@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/05/2018	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active	1-858-790-6682				HMO - Health Maintenance Organization		C	Atlanta
H2235	Pharmacy Network Management Contact	Manager, PNS & Claims Operations	Ms.	Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/05/2018	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2235	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	11/20/2020	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active	1-888-741-5002				HMO - Health Maintenance Organization		C	Atlanta
H2235	Plan to Plan Reconciliation Contact	Manager, Health Plan Finance		William	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/08/2019	2023	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2237	Automated TrOOP Balance Transfer Contact	Director of Pharmacy Services		Dykstra	Sarah		1-414-231-1178					sdykstra@icarehealthplan.org	1555 N Rivercenter Drive	Suite 206	Milwaukee	WI	53212	06/08/2021	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Chief Financial Officer	Chief Financial Officer	Ms	Bailey	Natalie		1-920-544-7034					nbailey1@humana.com	1100 Employers Boulevard		Green Bay	WI	54344	12/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	CMS Casework Communication Contact	Compliance		Fisher	Jill		1-414-225-4764					Jfisher@icarehealthplan.org	1555 N. RiverCenter Dr.		Milwaukee	WI	53212	06/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/27/2021	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Exceptions Contact	Director of Pharmacy Services		Dykstra	Sarah							sdykstra@icarehealthplan.org	1555 N Rivercenter Drive	Suite 206	Milwaukee	WI	53072	06/14/2021	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-414-231-1178				HMO - Health Maintenance Organization		C	Kansas City
H2237	Pharmacy Network Management Contact	Program Managers		Keller	Shanon		1-858-790-7104					Shanon.keller@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/10/2021	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Pharmacy Technical Help Desk Contact	Director, Contact Center Services		Battle	Dorry							dorry.battle@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-777-4376				HMO - Health Maintenance Organization		C	Kansas City
H2237	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2246	Automated TrOOP Balance Transfer Contact		Mr.	Williams	Steven		1-801-442-7801					steven.l.williams@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Best Available Evidence Contact	Medicare Enrollment Supervisor	Ms.	Baer	Mallory		1-801-442-9842					mallory.baer@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Chief Financial Officer	Chief Financial Officer	Mr.	Trettin	Todd		1-801-442-7760					todd.trettin@selecthealth.org	5381 S. Green Street		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	CMS Casework Communication Contact	Appeals and Grievances Director	Ms.	Johnson	Emily		1-801-442-7650					emily.johnson@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Coordination of Benefits Contact	ORBT Supervisor	Ms.	Aagard	Amanda		1-801-442-7006					Rxcob@imail.org	5381 S Green St		Murray	UT	84123	04/29/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Customer Service Operations Contact	Operations Manager	Mr.	Richins	JJ		1-801-442-8173					jj.richins@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Government Relations Contact	VP and Chief Administrative Officer	Ms.	McCullagh	Kristin		1-801-442-3436					kristin.mccullagh@selecthealth.org	5381 S Green St		Murray	UT	84123	04/29/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Hospice Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		1-801-442-7797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Schmidt	Cliff		1-801-442-7249					clifton.schmidt@selecthealth.org	5381 S Green St		Murray	UT	84123	10/27/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Part D Exceptions Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike							mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active	1-855-442-9900				PPO - BBA		C	Denver
H2246	Pharmacy Network Management Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		1-801-442-7797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2246	Pharmacy Technical Help Desk Contact	Pharmacy Operations Supervisor	Ms.	Rueckert	Stacey							stacey.rueckert@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active	1-855-442-9900				PPO - BBA		C	Denver
H2246	Plan to Plan Reconciliation Contact	Accounting Supervisor	Mr.	Applegarth	John		1-801-442-7980					john.applegarth@selecthealth.org	5381 S Green St		Murray	UT	84123	02/15/2022	2023	SELECTHEALTH, INC.	Local CCP	SelectHealth	Local PPO		Intermountain Health Care, Inc.	480	Yes	Active					PPO - BBA		C	Denver
H2247	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/17/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H2247	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2247	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H2247	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2256	Automated TrOOP Balance Transfer Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Best Available Evidence Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Chief Financial Officer	SVP Chief Financial Officer	Mr.	Kurpad	Umesh		1-781-612-1000	84968				umesh.kurpad@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	CMS Casework Communication Contact	Director, Appeals & Grievances	Ms.	Evans	Kathleen		1-617-972-9400	87204				kathleen.evans@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Coordination of Benefits Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Customer Service Operations Contact	Manager, Member Services	Ms.	Villatoro	Yesly		1-781-612-1000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Government Relations Contact	Chief Government Affairs Officer	Ms.	Lewis	Kristin		1-781-612-1000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Hospice Contact	Manager, Pharmacy Operations & Programs	Ms.	MacAuley	Jacqueline		1-781-612-1000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Taylor	James		1-781-612-1000	88089				james.taylor@point32health.org	1 Wellness Way		Canton	MA	02021	01/04/2023	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-781-612-1000	82370			HMO - Health Maintenance Organization		C	Boston
H2256	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/09/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	12/08/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-855-524-0380				HMO - Health Maintenance Organization		C	Boston
H2256	Plan to Plan Reconciliation Contact	Manager, Finance Operations	Ms.	Olson	Rachel		1-781-612-1000	84360				rachel.olson@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Automated TrOOP Balance Transfer Contact	Reporting Sr. Analyst		Kovalski	Robin		1-617-246-8586				1-617-246-8506	Robin.Kovalski@BCBSMA.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	02043-4359	08/04/2021	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Best Available Evidence Contact	Supervisor		Brown	Janice		1-617-246-8513				1-617-246-8506	janice.brown@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	02043-4359	03/28/2012	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Chief Financial Officer	Chief Financial Officer	Ms.	Santangelo	Andreana		1-617-246-3600					Andreana.Santangelo@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	02199-7611	12/19/2016	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	CMS Casework Communication Contact	Appeals and Grievance Manager		Ronaghan	Danielle		1-617-246-4663				1-617-246-8506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place	Mailstop 03-04	Hingham	MA	02043-4359	12/15/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Coordination of Benefits Contact	Specialist II Business Ops		Seesholtz	Janet		1-617-246-9587					Janet.Seesholtz@bcbsma.com	One Enterprise Drive		Quincy	MA	02171	05/26/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Customer Service Operations Contact	Member Service Director		Hanstein	deMarigny		1-617-246-8941					deMarigny.Hanstein@bcbsma.com	P. O. Box 55007		Boston	MA	02205-5007	11/18/2019	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Government Relations Contact	Senior Director of Federal and National Affairs		Savage	Deirdre		1-617-246-3359					deirdre.savage@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	02199-7611	06/09/2015	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Hospice Contact	Clinical Pharmacy Manager		Wong	Timothy		1-617-246-6927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	03/29/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Sullivan	Christina		1-781-603-8012					MAPDCompliance@bcbsma.com	25 Technology Place	Mail stop 03/04	Hingham	MA	02043-4359	04/28/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Part D Exceptions Contact	Director, Pharmacy Operations		Nelhuebel	Melinda						1-866-463-7700	Melinda.Nelhuebel@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/29/2018	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active	1-800-366-7778				HMO - Health Maintenance Organization		C	Boston
H2261	Pharmacy Network Management Contact	Lead Director, Network Management		Smith	Shawn		1-480-391-4844					Shawn.Smith@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	12/27/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Pharmacy Technical Help Desk Contact	Lead Director, Client Operations		Dayoub	Joselyn							Dayoubj@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	12/27/2022	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Boston
H2261	Plan to Plan Reconciliation Contact	Director, Corporate Accounting and Reporting		Thurber	Steven		1-617-246-6523				1-617-246-7806	Steven.Thurber@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	02199-7611	10/24/2019	2023	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Local CCP	Blue Cross Blue Shield of Massachusetts	HMO/HMOPOS		Blue Cross and Blue Shield of Massachusetts, Inc.	27	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H2272	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2272	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H2272	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	02/03/2022	2023	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2292	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H2292	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2292	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H2292	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2293	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Coordination of Benefits Contact	Consultant		Schultz	Valerie		1-952-594-6623					SchultzV@aetna.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Government Relations Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-707-5698				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Part D Exceptions Contact	Executive Director, Medicare Support		Jackson	Scott							Scott.Jackson@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-763-381-4676				PPO - BBA		C	Philadelphia
H2293	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/30/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2293	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-800-238-6279				PPO - BBA		C	Philadelphia
H2293	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/11/2022	2023	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H2318	Automated TrOOP Balance Transfer Contact	Director of Finance	Mrs.	Dresselhouse	Amy		1-248-556-9168				1-248-556-9150	amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	Best Available Evidence Contact	President & CEO	Ms.	Naber	Mary		1-855-445-4554				1-248-556-9150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	Chief Financial Officer	Chief Financial Officer	Mr.	Burmeister	Jeff		1-248-556-9132				1-248-556-9150	jeff.burmeister@pacesemi.org	21700 Northwester Highway		Southfield	MI	48075	05/09/2022	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	CMS Casework Communication Contact	Quality Director	Ms.	Diroff	Tracey		1-855-445-4554				1-248-556-9150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	Coordination of Benefits Contact	Director of Finance	Mrs.	Dresselhouse	Amy		1-248-556-9168				1-248-556-9150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	Customer Service Operations Contact	Senior Director of Operations	Ms.	White	Sandra		1-855-445-4554				1-248-556-9150	Sandra.White@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	Government Relations Contact	President & CEO	Ms.	Naber	Mary		1-855-445-4554				1-248-556-9150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	Medicare Compliance Officer	Quality Director	Ms.	Diroff	Tracey		1-855-445-4554				1-248-556-9150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	Part D Exceptions Contact	Director of Pharmacy	Mrs.	Rood	Janis							Janis.rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active	1-855-445-4554				PACE - Nat		C	Chicago
H2318	Pharmacy Network Management Contact	Director of Pharmacy	Ms.	Rood	Janis		1-248-223-7320					Janis.Rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2318	Pharmacy Technical Help Desk Contact	Director of Pharmacy	Ms.	Rood	Janis							Janis.Rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active	1-185-544-5455				PACE - Nat		C	Chicago
H2318	Plan to Plan Reconciliation Contact	Director of Finance	Mrs.	Dresselhouse	Amy		1-248-556-9168				1-248-556-9150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2023	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Chicago
H2320	Automated TrOOP Balance Transfer Contact	Enrollment Coordinator		Rice	Lori		1-616-464-8667					PH-MedicareTrOOPContact@PriorityHealth.com	1231 East Beltline Ave NE	MS 1175	Grand Rapids	MI	49525	03/21/2018	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Best Available Evidence Contact	Manager, Medicare Enrollment		Thomas	Sabrina		1-616-464-8578					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	09/30/2020	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Chief Financial Officer	Chief Financial Officer	Mr	Gates	Nick	P	1-616-464-8144					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	08/12/2021	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	CMS Casework Communication Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		1-917-841-7869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/14/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Coordination of Benefits Contact	Claims Manager		Ball	Jill		1-888-389-6648					CEOMedicare@priorityhealth.com	1239 East Beltline Ave NE	MS2205	Grand Rapids	MI	49525	04/14/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Customer Service Operations Contact	Customer Care Center Manager, Medicare		Storment	Joe		1-503-330-9550					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/07/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Government Relations Contact	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	02/16/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Hospice Contact	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	02/16/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Medicare Compliance Officer	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					charles.baker@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	02/16/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Part D Exceptions Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	02/04/2018	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	1-800-466-6642				HMO - Health Maintenance Organization		C	Chicago
H2320	Pharmacy Network Management Contact	Director Pharmacy Operations		Chaffee	Jacob		1-616-575-6149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2320	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	02/04/2018	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	1-800-466-6642				HMO - Health Maintenance Organization		C	Chicago
H2320	Plan to Plan Reconciliation Contact	Reconciliation & Billing Specialist		Bentley-Brown	Linda		1-616-464-8582				1-616-957-3420	linda.bentley-brown@priorityhealth.com	1231 East Beltline Ave NE	MS 1190	Grand Rapids	MI	49525	12/02/2014	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2322	Automated TrOOP Balance Transfer Contact	Medicare Part D Manager		Smith	Leah		1-313-664-8724					lsmith17@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	01/04/2021	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Best Available Evidence Contact	Manager, Membership & Billing		Mullins	Rhonda		1-248-443-7532					rmullins@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	12/22/2017	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Chief Financial Officer	SVP, Chief Financial Officer	Mr.	Hausenfluck	Merrill		1-248-776-3530					mhausen1@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	08/02/2022	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	CMS Casework Communication Contact	Appeals & Grievances Analyst	Ms.	Abazid	Wassan		1-313-664-8495				1-313-664-5845	wabazid@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	04/28/2021	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Coordination of Benefits Contact	VP- Claim Services		Palermo	Charles		1-248-443-8830					cpalermo@hap.org	2850 West Grand Blvd.		Detroit	MI	48202	01/03/2023	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Customer Service Operations Contact	Director	Ms	Pope	Venus		1-313-664-8933				1-313-664-8433	vpope@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	08/16/2017	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Government Relations Contact	Director, Government Programs Compliance	Ms	Randle	Johnathan		1-512-350-7810					jrandle4@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	04/22/2020	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Hospice Contact	Medicare Part D Manager		Smith	Leah		1-313-664-8724					lsmith17@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	01/04/2021	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Medicare Compliance Officer	Director	Mr.	Randle	Johnathan		1-512-350-7810					jrandle4@hap.org	1414 E Maple		Troy	MI	48303	08/25/2022	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Part D Exceptions Contact	Coordinator, Pharmacy Benefits		Yaldo	Traci							tyaldo@hap.org	2850 West Grand Blvd		Detroit	MI	48202	07/23/2019	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active	1-313-664-8607				PPO - BBA		C	Chicago
H2322	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2018	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2322	Pharmacy Technical Help Desk Contact	Director Customer Service		Monroe	LaTasha							latasha_monroe@express-scripts.com	13051 N. Telecom Parkway	Suite 150	Temple Terrace	FL	33637	12/14/2022	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H2322	Plan to Plan Reconciliation Contact	Accountant II		Nasser	Zeinat		1-248-443-2076					znasser@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	02/19/2020	2023	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active					PPO - BBA		C	Chicago
H2334	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	1-614-336-3326				PPO - BBA		C	Chicago
H2334	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2334	Pharmacy Technical Help Desk Contact			Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	08/04/2021	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H2334	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H2354	Automated TrOOP Balance Transfer Contact	Medicare Part D Manager		Smith	Leah		1-313-664-8724					lsmith17@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	01/04/2021	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Best Available Evidence Contact	Manager, Membership & Billing		Mullins	Rhonda		1-248-443-7532					rmullins@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	12/22/2017	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Chief Financial Officer	SVP, Chief Financial Officer	Mr.	Hausenfluck	Merrill		1-248-776-3530					mhausen1@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	08/02/2022	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	CMS Casework Communication Contact	Appeals & Grievances Analyst	Ms.	Abazid	Wassan		1-313-664-8495				1-313-664-5845	wabazid@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	04/28/2021	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Coordination of Benefits Contact	VP- Claim Services		Palermo	Charles		1-248-443-8830					cpalermo@hap.org	2850 West Grand Blvd.		Detroit	MI	48202	01/03/2023	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Customer Service Operations Contact	Director	Ms	Pope	Venus		1-313-664-8933				1-313-664-8433	vpope@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	08/16/2017	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Government Relations Contact	Director, Government Programs Compliance	Ms	Randle	Johnathan		1-512-350-7810					jrandle4@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	04/22/2020	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Hospice Contact	Medicare Part D Manager		Smith	Leah		1-313-664-8724					lsmith17@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	01/04/2021	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Medicare Compliance Officer	Director	Mr.	Randle	Johnathan		1-512-350-7810					jrandle4@hap.org	1414 E Maple		Troy	MI	48303	08/25/2022	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Part D Exceptions Contact	Medicare Part D Manager		Yaldo	Traci							tyaldo@hap.org	2850 West Grand Blvd		Detroit	MI	48202	01/04/2021	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	1-313-664-8607				HMO - Health Maintenance Organization		C	Chicago
H2354	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2018	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2354	Pharmacy Technical Help Desk Contact	Director Customer Service		Monroe	LaTasha							latasha_monroe@express-scripts.com	13051 N. Telecom Parkway	Suite 150	Temple Terrace	FL	33637	12/14/2022	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H2354	Plan to Plan Reconciliation Contact	Accountant II		Nasser	Zeinat		1-248-443-2076					znasser@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	02/19/2020	2023	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2368	Automated TrOOP Balance Transfer Contact	Director, PACE Finance		Hewitt	Jessica		1-720-974-6767				1-303-996-1600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/07/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-720-789-6171				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/07/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	Chief Financial Officer	CFO	Ms.	Gutierrez	Barbara		1-720-974-2434				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/07/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-804-543-0876				1-303-996-1600	epeak@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	10/01/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/27/2020	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	Customer Service Operations Contact	Regional Executive Director		Williams	Jeanette		1-909-677-9517				1-303-996-1600	JWilliams3@myinnovage.com	3870 Rosin Court		Sacramento	CA	95834	04/26/2022	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	Government Relations Contact	Executive VP Government Relations		Steckel	Carol		1-720-789-6157				1-303-996-1600	CSteckel@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/26/2022	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	Medicare Compliance Officer	VP of Pharmacy Services	Ms.	Chase	Darla		1-720-974-6785				1-303-996-1614	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/07/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	Part D Exceptions Contact	VP of Pharmacy Services	Ms.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/07/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	San Francisco
H2368	Pharmacy Network Management Contact	VP of Pharmacy Services	Ms.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/07/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2368	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Ms.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/07/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	San Francisco
H2368	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-720-974-6171				1-303-996-1600	AKizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/07/2021	2023	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H2384	Automated TrOOP Balance Transfer Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Best Available Evidence Contact			Hall	Kristi		1-650-336-0300					kristi.hall@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	06/10/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Chief Financial Officer		Mr.	Epstein	Ethan		1-203-695-1178					ethan.epstein@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	CMS Casework Communication Contact			Goel	Jyotika		1-619-746-2459					jyotika.goel@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Coordination of Benefits Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Customer Service Operations Contact			Wilds	Mindy		1-803-760-3916					Melinda.Wilds@welbehealth.com	1649 Van Ness Avenue		Fresno	CA	93721	02/16/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Government Relations Contact			Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Medicare Compliance Officer		Ms.	Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part D Exceptions Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	1-800-637-3187				PACE - Nat		C	San Francisco
H2384	Pharmacy Network Management Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Pharmacy Technical Help Desk Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	1-800-637-3187				PACE - Nat		C	San Francisco
H2384	Plan to Plan Reconciliation Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2386	Automated TrOOP Balance Transfer Contact	Program Director		Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	Best Available Evidence Contact	Program Director		Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	Chief Financial Officer	Chief Financial Officer	Ms.	Counts	Carolyn		1-276-964-4915	7103			1-276-963-0130	ccounts@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	CMS Casework Communication Contact	Program Director		Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	Coordination of Benefits Contact	Program Director		Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	Customer Service Operations Contact	Program Director	Ms.	Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	Government Relations Contact	Program Director		Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	Medicare Compliance Officer	Program Director	Ms.	Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	Part D Exceptions Contact	Program Director		Collins	Dana						1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active	1-800-656-2272	7152			PACE - Nat		C	Philadelphia
H2386	Pharmacy Network Management Contact	Program Director		Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2386	Pharmacy Technical Help Desk Contact	Clinical Pharmacist		Hackney	Jacqueline						1-276-964-7157	jhackney@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/29/2013	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active	1-866-828-7723				PACE - Nat		C	Philadelphia
H2386	Plan to Plan Reconciliation Contact	Program Director		Collins	Dana		1-276-964-4915	7152			1-276-963-0130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2023	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	National PACE	Appalachian Agency for Senior Citizens, Inc,	National PACE		Appalachian Agency for Senior Citizens, Inc.	365	Yes	Active					PACE - Nat		C	Philadelphia
H2392	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/18/2020	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H2392	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2392	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active	1-833-502-6757				HMO - Health Maintenance Organization		C	Dallas
H2392	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/12/2021	2023	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2400	Automated TrOOP Balance Transfer Contact			Meza	Josie		1-916-941-3501				1-916-941-3501	jmeza@envisionrx.com	EnvisionRx	1100 Investment Blvd.	El Dorado Hills	CA	95762	12/18/2017	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Best Available Evidence Contact	Director of Operations		Jackson	Samantha		1-636-614-1344					samantha.jackson@pillarrx.com	1061 Peruque Crossing Court		O'Fallon	MO	63366	08/27/2019	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Chief Financial Officer	CFO	Mr.	Aschenbeck	James		1-502-381-3442					jaschenbeck@signaturehealthcarellc.com	12201 Bluegrass Parkway		Louisville	KY	40299	09/30/2022	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Ingram	Kristie		1-502-410-6859					kingram@signaturehealthcarellc.com	12201 Bluegrass Parkway		Louisville	KY	40299	07/16/2021	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Coordination of Benefits Contact	CEO	Ms.	Haering	Shawna		1-502-568-7236					shaering@signaturehealthcarellc.com	12201 Bluegrass Parkway		Louisville	KY	40299	08/05/2021	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Customer Service Operations Contact	CEO	Ms	Haering	Shawna		1-502-568-7236					shaering@signaturehealthcarellc.com	12201 Bluegrass Parkway		Louisville	KY	40299	08/05/2021	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Government Relations Contact	Chief Compliance Officer	Ms.	Ingram	Kristie		1-502-410-6859					kingram@signaturehealthcarellc.com	12201 Bluegrass Parkway		Louisville	KY	40299	07/16/2021	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Hospice Contact	VP, Clinical Services		Probus	Candice		1-502-709-0893					Candice.Probus@signatureadvantageplan.com	12201 Bluegrass Parkway		Louisville	KY	40299	07/01/2021	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Ingram	Kristie		1-502-410-6859					kingram@signaturehealthcarellc.com	12201 Bluegrass Parkway		Louisville	KY	40299	07/16/2021	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Exceptions Contact	AVP, Clinical Ops		Lavignette	Amanda							acollins@envisionrx.com	EnvisionRx, 2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	12/23/2020	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active	1-234-212-3643				HMO - Health Maintenance Organization		C	Philadelphia
H2400	Pharmacy Network Management Contact	Director Pharmacy Network Development & Operations		Profio	Lauren		1-330-486-4864					lprofio@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/01/2022	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							tconn@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/01/2022	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active	1-833-803-4397				HMO - Health Maintenance Organization		C	Philadelphia
H2400	Plan to Plan Reconciliation Contact	CFO		Aschenbeck	James		1-502-381-3442					jaschenbeck@signaturehealthcarellc.com	12201 Bluegrass Parkway		Louisville	KY	40299	09/30/2022	2023	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		SA Plan, LLC	620	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2406	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H2406	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2406	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H2406	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/23/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2416	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Ehlert	Ann		1-320-759-4154				1-320-762-5945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Best Available Evidence Contact	Manager of Enrollment	Ms.	Jirik	Becky		1-320-335-5219				1-320-335-5223	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	04/02/2018	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Chief Financial Officer	Chief Financial Officer	Mr.	Tava	Alex		1-651-389-4570				1-651-228-9893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500,	St. Paul	MN	55101	10/24/2019	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	CMS Casework Communication Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		1-320-335-5392				1-320-762-8750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Coordination of Benefits Contact	Manager of Enrollment	Ms.	Jirik	Becky		1-320-335-5219				1-320-335-5223	MedicareCOB@primewest.org	PrimeWest Health	3905 Dakota Street	Alexandria	MN	56309	04/12/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Customer Service Operations Contact	Director of Membership & Program Development	Mr.	Magnuson	Matt		1-320-335-5243				1-320-335-5223	matt.magnuson@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Government Relations Contact	Chief Executive Officer	Mr.	Przybilla	James		1-320-335-5250				1-320-335-5339	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Hospice Contact	Director of Pharmacy	Ms.	Ehlert	Ann		1-320-759-4154				1-320-762-5945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota Street	Alexandria	MN	56308	09/15/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Medicare Compliance Officer	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		1-320-335-5399				1-320-762-5937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Part D Exceptions Contact	Director of Pharmacy	Ms.	Ehlert	Ann						1-320-762-5945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	1-320-759-4154				HMO - Health Maintenance Organization		C	Chicago
H2416	Pharmacy Network Management Contact	Dir Pharmacy Network Administration	Mr.	Hunt	Brian		1-858-790-7092					Brian.Hunt@MedImpact.com	MedImpact HealthCare Systems Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	12/13/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2416	Pharmacy Technical Help Desk Contact	Director Customer Contact Services	Ms.	Brewer	Kathy							customerservice@medimpact.com	MedImpact HealthCare Systems, Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	06/17/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	1-877-391-9294				HMO - Health Maintenance Organization		C	Chicago
H2416	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Tava	Alex		1-651-389-4570				1-651-228-9893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Automated TrOOP Balance Transfer Contact	Data/Project Coordinator		Erickson	Myranda		1-218-327-6157				1-218-327-5545	myranda.erickson@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	10/18/2017	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Best Available Evidence Contact	Data/Project Coordinator		Chambers	Mary		1-218-327-5505				1-218-327-5545	mary.chambers@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	03/07/2022	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Chief Financial Officer	CFO	Mr.	Alstad	Matthew		1-218-327-5517				1-218-327-5545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	CMS Casework Communication Contact	Contract Compliance Officer		Grover	Laura		1-218-327-6769				1-218-327-5545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Coordination of Benefits Contact	Data/Project Coordinator		Chambers	Mary		1-218-327-5505				1-218-327-5545	imcareenrollment@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	05/10/2022	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Customer Service Operations Contact	Contract Compliance Officer		Grover	Laura		1-218-327-6769				1-218-327-5545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Government Relations Contact	Contract Compliance Officer		Grover	Laura		1-218-327-6769				1-218-327-5545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Hospice Contact	Data/Project Coordinator		Chambers	Mary		1-218-327-5505				1-218-327-5545	mary.chambers@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	03/07/2022	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Medicare Compliance Officer	Contract Compliance Officer	Ms.	Grover	Laura		1-218-327-6769				1-218-327-5545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Part D Exceptions Contact	Utilization Management Director		Rosik	Peggy						1-218-327-5545	peggy.rosik@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/15/2021	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active	1-800-843-9536	2199			HMO - Health Maintenance Organization		C	Chicago
H2417	Pharmacy Network Management Contact	Director Network Systems and Standard		Tressler	Damon		1-480-391-4702					damon.tressler@caremark.com	9501 E Shea Blvd.		Scottsdale	AZ	85260	12/15/2006	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Pharmacy Technical Help Desk Contact	IMCARE MEMBER SERVICES		SERVICES	MEMBER						1-218-327-5545		1219 SE 2ND AVENUE		GRAND RAPIDS	MN	55744	02/28/2019	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active	1-800-843-9536				HMO - Health Maintenance Organization		C	Chicago
H2417	Plan to Plan Reconciliation Contact	Data/Project Coordinator		Chambers	Mary		1-218-327-5505				1-218-327-5545	mary.chambers@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	03/07/2022	2023	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Automated TrOOP Balance Transfer Contact	Manager of Technical Delivery and Oversight		Gajarajan	Nivi		1-267-825-8648					ngajarajan2@performrx.com	PerformRx	200 Steven Dr.	Philadelphia	PA	19113	05/26/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Best Available Evidence Contact	Director of Operations		Lewer	Cheryl		1-507-431-6377				1-507-444-7774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Chief Financial Officer	Chief Financial Officer	Mr	Schufman	Scott		1-507-431-6599				1-507-444-7774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	CMS Casework Communication Contact	Grievance and Appeals Manager		Miller	Suzette		1-507-431-6373				1-507-444-7774	sumiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Coordination of Benefits Contact	Director of Operations		Lewer	Cheryl		1-507-431-6377				1-507-444-7774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Customer Service Operations Contact	Director of Operations		Lewer	Cheryl		1-507-431-6377				1-507-444-7774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Government Relations Contact	Compliance and Government Relations Manager		Krenz	Kayla		1-507-431-6938				1-507-444-7774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Hospice Contact	Director of Health Services		Worrall	Kim		1-507-431-6397				1-507-444-7774	kworrall@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Medicare Compliance Officer	Compliance Officer	Mr	Marks	Jeff		1-507-431-6068				1-507-444-7774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Part D Exceptions Contact	Director of Pharmacy Utilization Management		Bonko	Gerald						1-215-863-5100	gbonko@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/01/2016	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	1-215-863-6483				HMO - Health Maintenance Organization		C	Chicago
H2419	Pharmacy Network Management Contact	Director, Service Operations		Leal	Avelina		1-215-863-6540					aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	04/28/2022	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Pharmacy Technical Help Desk Contact	Director, Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/04/2015	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	1-866-935-6681				HMO - Health Maintenance Organization		C	Chicago
H2419	Plan to Plan Reconciliation Contact	Controller		Toquam	Erica		1-507-431-6591				1-507-444-7774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Automated TrOOP Balance Transfer Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	1-952-883-6536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Best Available Evidence Contact	Manager Membership Accounting		Marty	Amanda	E	1-952-967-7685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	55440-1309	11/05/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Chief Financial Officer	EVP & Chief Financial Officer	Ms.	Cermak	Penny	D	1-952-883-7918					penny.d.cermak@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	55440-1309	09/13/2022	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	CMS Casework Communication Contact	Manager, Member Rights and Benefits		Kruse	Morgan	L	1-952-967-7679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	55440-9463	12/02/2022	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Coordination of Benefits Contact	Manager, Claims Production		Prine	Chantelle	M	1-952-967-7335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	55440-1309	04/20/2022	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Customer Service Operations Contact	Director Member Services		Renneke	Alison		1-952-967-7668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	55440-9463	01/29/2020	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Government Relations Contact	VP Government Programs		Clelland	Jennifer	J	1-952-967-5119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	55440-1309	08/27/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Hospice Contact	Pharmacy Compliance Specialist		Riggs	Ben	H	1-952-851-8421					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Medicare Compliance Officer	VP Internal Audit Comp Officer	Mr.	Bunde	Steven	D	1-952-883-6541				1-952-883-5522	steven.d.bunde@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	12/03/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Exceptions Contact	Supervisor, Clinical Review		Whelan	Hillary	A					1-952-853-8700	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/30/2020	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active	1-800-492-7259				HMO - Health Maintenance Organization		C	Chicago
H2422	Pharmacy Network Management Contact	Director Pharmacy Sales & Product Support		Friday	Ken	R	1-952-967-5826				1-952-967-6667	kenneth.r.friday@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Pharmacy Technical Help Desk Contact	Manager Health Plan Pharmacy Customer Service		Whelan	Hillary	A					1-888-883-5434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/19/2022	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active	1-800-492-7259				HMO - Health Maintenance Organization		C	Chicago
H2422	Plan to Plan Reconciliation Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	1-952-883-6584				1-952-883-6500	kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	55440-1309	05/09/2013	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Automated TrOOP Balance Transfer Contact	Director, PBM Operations		Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/21/2022	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Best Available Evidence Contact	Manager, Business Services		Daniels	Cassandra		1-651-662-3468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Dr		Eagan	MN	55121	02/02/2022	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Chief Financial Officer	Senior Vice President, Chief Financial Officer	Mr.	Uribe	John		1-651-662-9501					John.Uribe@bluecrossmn.com	1800 Yankee Doodle Road		Eagan	MN	55121	06/03/2022	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	CMS Casework Communication Contact	Manager Consumer Service Center		Brown	Robyn		1-651-662-7446					robyn.brown@bluecrossmn.com	1800 Yankee Doodle Road		Eagan	MN	55121	07/17/2019	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Coordination of Benefits Contact	Director, PBM Operations		Allie	Cindy		1-612-777-6722				1-612-777-6705	COBmedd@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/21/2022	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Customer Service Operations Contact	Director, Business Transformation		Hovick	Denise		1-651-662-8864					denise.hovick@bluecrossmn.com	3535 Blue Cross Road		Eagan	MN	55122	04/21/2022	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Government Relations Contact	VP Public Affairs		Keefer	Scott		1-651-662-8786					scott.keefer@bluecrossmn.com	3535 Blue Cross Road		Eagan	MN	55121	12/13/2021	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Hospice Contact	Operations Business Analyst		Dick	Beth		1-651-662-9644					beth.dick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/11/2019	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Medicare Compliance Officer	Government Compliance Officer	Ms.	Hogan	Carrie		1-651-662-1900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Exceptions Contact	Med D Coverage		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/31/2021	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Chicago
H2425	Pharmacy Network Management Contact	AVP, Network Mangement		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/31/2021	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Pharmacy Technical Help Desk Contact	Director, Member Services		Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	06/30/2021	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active	1-800-648-2778				HMO - Health Maintenance Organization		C	Chicago
H2425	Plan to Plan Reconciliation Contact	Manager, Financial Reporting		Harrelson	Michael		1-651-662-8490				1-651-662-2200	Michael.Harrelson@bluecrossmn.com	3535 Blue Cross Rd		Eagan	MN	55122	10/18/2019	2023	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2450	Automated TrOOP Balance Transfer Contact			Bean	Danielle		1-952-992-2864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Best Available Evidence Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Chief Financial Officer		Ms	Quist	Mary		1-952-992-2058					mary.quist@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	CMS Casework Communication Contact			Sikorski	TJ		1-952-992-8542				1-952-992-8492	thomas.sikorski@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/04/2023	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Coordination of Benefits Contact			Vilendrer	Krista		1-952-992-3252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Customer Service Operations Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Government Relations Contact			Kinsella	Ann		1-952-992-3832					ann.kinsella@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/21/2021	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Hospice Contact			Bourdages	Kathy		1-952-992-3653				1-952-992-3636	PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/31/2018	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Medicare Compliance Officer		Mrs	Koranteng	Milly		1-952-992-2090					mildred.koranteng@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/22/2020	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/28/2016	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active	1-952-992-2353				Cost1		1	Kansas City
H2450	Pharmacy Network Management Contact			Dornbrook-Lavender	Kimberly		1-952-992-3448					kimberly.dornbrook-lavender@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	La Tasha							LaTasha_Monroe@expressscripts.com	13051 N. Telecom Pkwy		Temple Terrace	FL	33637	11/17/2021	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active	1-800-922-1557				Cost1		1	Kansas City
H2450	Plan to Plan Reconciliation Contact			Cameron	Andrew		1-952-992-2386					Andrew.Cameron@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	11/12/2021	2023	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2456	Automated TrOOP Balance Transfer Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	08/16/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Best Available Evidence Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					mjohnson4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/16/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Chief Financial Officer	SVP and Chief Financial Officer	Ms.	Monsrud	Beth		1-612-676-3217				1-612-676-6501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	11/30/2015	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	CMS Casework Communication Contact	A&G Regulatory and Compliance Specialist		Wood	Nakia		1-612-294-5668					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Coordination of Benefits Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Customer Service Operations Contact	CS Support Services Sr Manager		Vang	Pakou		1-612-676-3585					pvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Government Relations Contact	Federal Government Relations Specialist		Vang	Julie		1-612-294-5654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/30/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Hospice Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051					pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	McMahon	Jane		1-612-456-7817					federalgrleadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	07/27/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Part D Exceptions Contact	Vice President Pharmacy Management		Mitsch	Patrick						1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	1-612-294-5051				HMO - Health Maintenance Organization		C	Chicago
H2456	Pharmacy Network Management Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2456	Pharmacy Technical Help Desk Contact	Director, Customer Service		Warren	Mark							mwarren@express-scripts.com	6625 West 78th Street		Minneapolis	MN	55439	11/30/2020	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H2456	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		1-612-676-3213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/04/2013	2023	UCARE MINNESOTA	Local CCP	UCare's MSHO	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2458	Automated TrOOP Balance Transfer Contact			Bean	Danielle		1-952-992-2864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Best Available Evidence Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Chief Financial Officer		Ms	Quist	Mary		1-952-992-2058					mary.quist@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	CMS Casework Communication Contact			Sikorski	TJ		1-952-992-8542				1-952-992-8492	thomas.sikorski@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/04/2023	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Coordination of Benefits Contact			Vilendrer	Krista		1-952-992-3252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Customer Service Operations Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Government Relations Contact			Kinsella	Ann		1-952-992-3832					ann.kinsella@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/21/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Hospice Contact			Bourdages	Kathy		1-952-992-3653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Medicare Compliance Officer		Mrs	Koranteng	Milly		1-952-992-2090					mildred.koranteng@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/22/2020	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/28/2016	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-952-992-2353				HMO - Health Maintenance Organization		C	Kansas City
H2458	Pharmacy Network Management Contact			Dornbrook-Lavender	Kimberly		1-952-992-3448					kimberly.dornbrook-lavender@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2458	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	La Tasha							LaTasha_Monroe@expressscripts.com	13051 N. Telecom Pkwy		Temple Terrace	FL	33637	11/17/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Kansas City
H2458	Plan to Plan Reconciliation Contact			Cameron	Andrew		1-952-992-2386					Andrew.Cameron@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	11/12/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2459	Automated TrOOP Balance Transfer Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	08/16/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Best Available Evidence Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					mjohnson4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/16/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Chief Financial Officer	SVP and Chief Financial Officer	Ms.	Monsrud	Beth		1-612-676-3217				1-612-676-6501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	11/30/2015	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	CMS Casework Communication Contact	A&G Regulatory and Compliance Specialist		Wood	Nakia		1-612-294-5668					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Coordination of Benefits Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Customer Service Operations Contact	CS Support Services Sr Manager		Vang	Pakou		1-612-676-3585					pvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Government Relations Contact	Federal Government Relations Specialist		Vang	Julie		1-612-294-5654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/30/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Hospice Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051					pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	McMahon	Jane		1-612-456-7817					federalgrleadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	07/27/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Part D Exceptions Contact	Vice President Pharmacy Management		Mitsch	Patrick						1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	1-612-294-5051				HMO - Health Maintenance Organization		C	Chicago
H2459	Pharmacy Network Management Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2459	Pharmacy Technical Help Desk Contact	Director, Customer Service		Warren	Mark							mwarren@express-scripts.com	6625 West 78th Street		Minneapolis	MN	55439	11/30/2020	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H2459	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		1-612-676-3213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/04/2013	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2461	Automated TrOOP Balance Transfer Contact	Director PBM Operations		Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/21/2022	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Best Available Evidence Contact	Manager, Business Services		Daniels	Cassandra		1-651-662-3468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Dr		Eagan	MN	55121	02/02/2022	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Chief Financial Officer	Senior Vice President, Chief Financial Officer	Mr.	Uribe	John		1-651-662-9501					John.Uribe@bluecrossmn.com	1800 Yankee Doodle Road		Eagan	MN	55121	06/03/2022	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	CMS Casework Communication Contact	Manager Consumer Service Center		Brown	Robyn		1-651-662-7446					robyn.brown@bluecrossmn.com	1800 Yankee Doodle Road		Eagan	MN	55121	07/17/2019	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Coordination of Benefits Contact	Business Services  Mgr		Daniels	Cassandra		1-651-662-3468					government.program.service.request@bcbsmn.com	3400 Yankee Dr		Eagan	MN	55122	06/28/2022	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Customer Service Operations Contact	Director, Business Transformation		Hovick	Denise		1-651-662-8864					denise.hovick@bluecrossmn.com	3535 Blue Cross Road		Eagan	MN	55122	04/21/2022	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Government Relations Contact	VP Public Affairs		Keefer	Scott		1-651-662-8786					scott.keefer@bluecrossmn.com	3535 Blue Cross Road		Eagan	MN	55121	12/13/2021	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Hospice Contact	Operations Business Analyst		Dick	Beth		1-651-662-9644					beth.dick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/19/2019	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Medicare Compliance Officer	Government Compliance Officer	Ms.	Hogan	Carrie		1-651-662-1900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Part D Exceptions Contact	Med D Coverage		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/31/2021	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active	1-800-693-6651				Cost1		1	Chicago
H2461	Pharmacy Network Management Contact	AVP, Network Mangement		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/31/2021	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Pharmacy Technical Help Desk Contact	Director, Member Services		Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	06/30/2021	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active	1-800-648-2778				Cost1		1	Chicago
H2461	Plan to Plan Reconciliation Contact	Manager, Financial Reporting		Harrelson	Michael		1-651-662-8490				1-651-662-2200	Michael.Harrelson@bluecrossmn.com	3535 Blue Cross Rd		Eagan	MN	55122	01/28/2018	2023	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2462	Automated TrOOP Balance Transfer Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	1-952-883-6536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Best Available Evidence Contact	Manager Membership Accounting		Marty	Amanda	E	1-952-967-7685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	55440-1309	11/05/2021	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Chief Financial Officer	EVP & Chief Financial Officer	Ms.	Cermak	Penny	D	1-952-883-7918					penny.d.cermak@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	55440-1309	09/13/2022	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	CMS Casework Communication Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	1-952-967-7679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	55440-9463	12/02/2022	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Coordination of Benefits Contact	Manager, Claims Production		Prine	Chantelle	M	1-952-967-7335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	55440-1309	04/20/2022	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Customer Service Operations Contact	Director Member Services		Renneke	Alison		1-952-967-7668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	55440-9463	01/29/2020	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Government Relations Contact	VP Government Programs		Clelland	Jennifer	J	1-952-967-5119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	55440-1309	08/30/2021	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Hospice Contact	Pharmacy Compliance Specialist		Riggs	Ben	H	1-952-851-8421					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Medicare Compliance Officer	VP Internal Audit Comp Officer	Mr.	Bunde	Steven	D	1-952-883-6541				1-952-883-5522	steven.d.bunde@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	12/03/2021	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part D Exceptions Contact	Supervisor, Clinical Review		Whelan	Hillary	A					1-888-883-5434	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active	1-800-492-7259				Cost1		1	Chicago
H2462	Pharmacy Network Management Contact	Director Pharmacy Sales & Product Support		Friday	Ken	R	1-952-967-5826				1-952-967-6667	kenneth.r.friday@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Pharmacy Technical Help Desk Contact	Manager Health Plan Pharmacy Customer Service		Whelan	Hillary	A					1-888-883-5434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/19/2022	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active	1-800-492-7259				Cost1		1	Chicago
H2462	Plan to Plan Reconciliation Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	1-952-883-6584				1-952-883-6500	kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	55440-1309	05/09/2013	2023	GROUP HEALTH PLAN, INC. (MN)	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2463	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H2463	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H2463	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2478	Automated TrOOP Balance Transfer Contact	MHI- VP, Medicare Finance, CFO		Wilson	David	S	1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/16/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Chief Financial Officer	MHI- VP, Medicare Finance, CFO	Mrs.	Wilson	David	S	1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/16/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	02/13/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	02/13/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	02/13/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H2478	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2478	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H2478	Plan to Plan Reconciliation Contact	MHI- VP, Medicare Finance, CFO		Wilson	David	S	1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/16/2022	2023	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2486	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H2486	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H2486	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2491	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H2491	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2491	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H2491	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2506	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Best Available Evidence Contact	Sr. Compliance Lead		Travis	Denise		1-312-928-3021				1-855-454-8052	TravisL@aetna.com	333 W Wacker Drive		Chicago	IL	60606	11/30/2018	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	05/04/2020	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	CMS Casework Communication Contact	Lead Director		Leskovac	Tara		1-614-563-7807					leskovact@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/20/2022	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Coordination of Benefits Contact	Phamacy Director		Vergil	Gina		1-402-699-7768					VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/28/2020	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		1-866-600-2139					PhillipsL1@aetna.com	7400 Camous Road		New Albany	OH	43054	07/19/2019	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Government Relations Contact	Vice President, Duals Markets	Mr	Smith	Jason		1-614-551-4237					SmithT25@aetna.com	4500 E. Cotton Center Blvd.		Phoenix	AZ	85040	01/13/2022	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Hospice Contact	Director, Service Operations		Truitt	Michelle		1-717-671-6847					MLTruitt@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	07/01/2020	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Part D Exceptions Contact	Pharmacy Director		Vergil	Gina							Vergilg@aetna.com	7400 West Campus Road		New Albany	OH	43054	01/13/2022	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-402-699-7768				Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Pharmacy Network Management Contact	Pharmacy Director		Nkurunziza	Natalie		1-860-900-6247					NkurunzizaN@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	09/20/2022	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Pharmacy Technical Help Desk Contact	Phamacy Director		Nkurunziza	Natalie							NkurunzizaN@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	09/20/2022	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-855-364-2974				Demo Risk Option C	MMP HMO Demo	C	Chicago
H2506	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	Aetna Better Health Premier Plan MMAI Inc.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2509	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H2509	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2509	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H2509	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	02/03/2022	2023	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2526	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H2526	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H2526	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2531	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/17/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	09/15/2022	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Demo Risk Option C	MMP HMO Demo	C	Chicago
H2531	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/23/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Demo	UnitedHealthcare Community Plan	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H2533	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Government Relations Contact	Lead, Government Contracts		Simmons	LaDawn		1-843-501-9132					Ladawn.Simmons@molinahealthcare.com	4105 Faber Place Dr		North Charleston	SC	29405	11/18/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/05/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2533	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Demo	Molina Healthcare of South Carolina	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H2537	Automated TrOOP Balance Transfer Contact	Accountant	Ms	Eckard	Karla		1-717-264-8178					kaeckard@spiritrustlutheranhc.org	2700 Luther Drive		Chambersburg	PA	17202	07/25/2019	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	Best Available Evidence Contact	Medical Director	Dr	Diduszyn	Jorge		1-717-264-5433				1-717-264-3279	jdiduszyn@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersburg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	Chief Financial Officer	CEO	Mr	Rundle	Bob		1-717-487-6239					brundle@spiritrustlutheran.org	1050 Pennsylvania Avenue		York	PA	17404	06/04/2021	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	CMS Casework Communication Contact	Director, Life Services	Dr	Bradish	Blake		1-717-264-5433				1-717-264-3279	bbradish@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersburg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	Coordination of Benefits Contact	Director, Life Services	Dr	Bradish	Blake		1-717-264-5433				1-717-264-3279	bbradish@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersburg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	Customer Service Operations Contact	Director, Life Services	Dr	Bradish	Blake		1-717-264-5433				1-717-264-3279	bbradish@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersurg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	Government Relations Contact	Director, Life Services	Dr	Bradish	Blake		1-717-264-5433				1-717-264-3279	bbradish@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersburg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	Medicare Compliance Officer	Corporate Director of Compliance	Ms.	Keller	Liz		1-717-372-3234				1-717-264-6347	LKeller@spiritrustlutheranhomecare.org	2700 Luther Drive		Chambersburg	PA	17202	08/16/2022	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	Part D Exceptions Contact	Director, Life Services	Dr	Bradish	Blake							bbradish@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersburg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active	1-717-264-5433				PACE - Nat		C	Philadelphia
H2537	Pharmacy Network Management Contact	Director, Life Services	Dr	Bradish	Blake		1-717-264-5433				1-717-264-3279	bbradish@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersburg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2537	Pharmacy Technical Help Desk Contact	Director, Life Services	Dr	Bradish	Blake						1-717-264-3279	bbradish@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersburg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active	1-717-264-5433				PACE - Nat		C	Philadelphia
H2537	Plan to Plan Reconciliation Contact	Director, Life Services	Dr	Bradish	Blake		1-717-264-5433				1-717-264-3279	bbradish@spiritrustlutheranlife.org	840 Fifth Avenue		Chambersburg	PA	17201	11/25/2020	2023	SPIRITRUST LUTHERAN LIFE	National PACE	SpiriTrust Lutheran LIFE	National PACE		SpiritTrust Lutheran	390	Yes	Active					PACE - Nat		C	Philadelphia
H2541	Automated TrOOP Balance Transfer Contact	Geriatric Services Director	Ms	Stambaugh	Kathryn		1-510-981-4156				1-415-897-1585	kstambaugh@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	Best Available Evidence Contact	Geriatric Services Director	Ms	Stambaugh	Kathryn		1-510-981-4156				1-415-897-1585	kstambaugh@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	Chief Financial Officer	CFO	Mr	Copen	Brent		1-510-981-4122				1-510-981-4191	Bcopen@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	CMS Casework Communication Contact	Geriatric Services Director	Ms	Stambaugh	Kathryn		1-510-981-4156				1-415-897-1585	kstambaugh@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	Coordination of Benefits Contact	Geriatric Services Director	Ms	Stambaugh	Kathryn		1-510-981-4156				1-415-897-1585	kstambaugh@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	Customer Service Operations Contact	Geriatric Services Director	Ms	Stambaugh	Kathryn		1-510-981-4156				1-415-897-1585	kstambaugh@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	Government Relations Contact	Geriatric Services Director	Ms	Stambaugh	Kathryn		1-510-981-4156				1-415-897-1585	kstambaugh@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	Medicare Compliance Officer	CFO	Mr	Fleischer-Ihn	Stephen		1-510-981-3205				1-510-549-5458	stfihn@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	Part D Exceptions Contact	Special Population Programs Director	Mr	Leroi	Ben							benl@srhealth.org	3569 Round Barn Circle		Santa Rosa	CA	95403	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending	1-707-303-3600				PACE - Nat		C	San Francisco
H2541	Pharmacy Network Management Contact	Geriatric Services Director	Ms	Stambaugh	Kathryn		1-510-981-4156				1-415-897-1585	kstambaugh@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2541	Pharmacy Technical Help Desk Contact	Special Population Programs Director	Mr	Leroi	Ben							benl@srhealth.org	3569 Round Barn Circle		Santa Rosa	CA	95403	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending	1-707-303-3600				PACE - Nat		C	San Francisco
H2541	Plan to Plan Reconciliation Contact	CFO	Mr	Copen	Brent		1-510-981-4122				1-510-981-4191	Bcopen@lifelongmedical.org	2344 Sixth Street		Berkeley	CA	94710	12/07/2021	2023	AGEWELL PACE	National PACE	AgeWell PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H2563	Automated TrOOP Balance Transfer Contact	Director of Pharmacy Ops & Compliance		May	Crystal		1-804-687-8378				1-757-692-5575	RxBenefits@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Best Available Evidence Contact	Director Enrollment & Disenrollment		Brown	Sheila		1-757-252-8015				1-757-692-5575	sxbrown29@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Chief Financial Officer	Director Medicare Finance	Ms.	Eagleson	Leigh		1-443-851-6654				1-757-552-7396	laeagles@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	CMS Casework Communication Contact	Manager Regulatory Compliance		Monroe	Latasha		1-804-721-7037					lajones4@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Coordination of Benefits Contact	Direct Ops Support		Driskill	Kenneth		1-804-819-5151				1-757-687-6231	kwdriski@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Customer Service Operations Contact	Director, Customer Services		Brogan	Kim		1-757-434-9999				1-757-552-7116	krbrogan@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Government Relations Contact	Director Government Programs - Medicare		Hoffman	Daniel		1-757-983-2540				1-757-552-7396	dehoffma@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Hospice Contact	Manager Pharmacy Benefits	Ms.	Strickland	Brandi		1-757-252-8193					RxBenefits@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Green	Janet		1-813-368-2227					JLGREE13@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	08/30/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Part D Exceptions Contact	Clinical Pharmacist Medicare		Snow	Michael						1-757-962-5575	mzsnow@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	12/27/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	1-757-983-4243				HMO - Health Maintenance Organization		C	Philadelphia
H2563	Pharmacy Network Management Contact	VP, Pharmacy		Daw	Jessica		1-757-252-8181				1-757-962-5575	jrdaw@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	10/28/2019	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2563	Pharmacy Technical Help Desk Contact	Mgr Pharmacy Help Desk		Summers	Todd							todd.summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	11/12/2021	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	1-866-603-7514				HMO - Health Maintenance Organization		C	Philadelphia
H2563	Plan to Plan Reconciliation Contact	Accounting Manager		Duncan	April		1-757-252-8055				1-757-252-8030	acmorgan@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	06/04/2018	2023	OPTIMA HEALTH PLAN	Local CCP	Optima Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2577	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/24/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/15/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/24/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/24/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/24/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H2577	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/24/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2577	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	10/24/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H2577	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	10/24/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H2582	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/24/2019	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	CMS Casework Communication Contact	Director Medicare Programs & Compliance Systems		Keele	Melissa		1-970-263-5546					melissa.keele@uhc.com	PO Box 10600		Grand Junction	CO	81502	12/01/2021	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	10/24/2019	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Customer Service Operations Contact			Service	Customer		1-800-346-4643					customer_service@rmhp.org	PO Box 10600		Grand Junction	CO	81506	10/30/2019	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/08/2019	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	06/11/2020	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/08/2019	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H2582	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/08/2019	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2582	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	11/08/2019	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H2582	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	11/08/2019	2023	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC	Local CCP	Rocky Mountain Health Plans	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2591	Automated TrOOP Balance Transfer Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Best Available Evidence Contact	Medicare Enrollment Manager		Kirby	Rae		1-217-902-9108					rae.kirby@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Chief Financial Officer	Chief Financial Officer	Mr.	Bradford	Jerry		1-217-902-9002				1-217-902-9740	Jerry.Bradford@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	10/18/2021	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	CMS Casework Communication Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Coordination of Benefits Contact	Director of Claims & Recovery		Parker	Lisa		1-217-902-8353				1-217-902-9786	lisa.parker@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Customer Service Operations Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Government Relations Contact	CEO		Madigan	Sinead		1-217-902-8301				1-217-902-9740	sinead.madigan@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Hospice Contact	Director of Pharmacy		Buhr	Aimee		1-217-902-9366					Aimee.Buhr@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Medicare Compliance Officer	VP, Chief Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Part D Exceptions Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active	1-217-902-8224				PPO - BBA		C	Chicago
H2591	Pharmacy Network Management Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2591	Pharmacy Technical Help Desk Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active	1-844-265-1876				PPO - BBA		C	Chicago
H2591	Plan to Plan Reconciliation Contact			Tizora	Elizabeth		1-217-902-9469					elizabeth.tizora@healthalliance.org	3310 Fields South Dr		Champaign	IL	61822	03/14/2019	2023	HEALTH ALLIANCE - MIDWEST, INC.	Local CCP	Health Alliance Medicare	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H2593	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H2593	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H2593	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	AMERIGROUP TEXAS, INC.	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2610	Automated TrOOP Balance Transfer Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/08/2021	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Best Available Evidence Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/08/2021	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Chief Financial Officer	Chief Financial Officer	Mr.	Grabski	Ben		1-763-300-7611					bgrabski@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	CMS Casework Communication Contact	Sr. Director Compliance	Mr.	Whitbeck	Britton		1-314-209-3989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/07/2022	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Coordination of Benefits Contact			Inquiries	COB		1-866-597-9560					COBInquiry@lumeris.com	P O BOX 5907		TROY	MI	48007	12/06/2022	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoffer	Linda		1-636-686-9682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2021	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		1-314-209-2717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/17/2019	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Hospice Contact	Director, Pharmacy		Cruz	Jennifer		1-314-770-3556					pharmacy@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/05/2018	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Medicare Compliance Officer	VP Internal Audit and Chief Compliance Officer	Ms.	Venable	Erin		1-314-209-3957					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/17/2019	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Part D Exceptions Contact		Ms.	Byers	June							June.Byers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/29/2014	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				HMO - Health Maintenance Organization		C	Kansas City
H2610	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/17/2019	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2610	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/02/2020	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				HMO - Health Maintenance Organization		C	Kansas City
H2610	Plan to Plan Reconciliation Contact	Manager, Client Payments		Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/06/2021	2023	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2624	Automated TrOOP Balance Transfer Contact	Manager, Business Systems & Data		rao	Chanukya		1-508-804-6892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Best Available Evidence Contact	Director of Enrollment		Felver	Steven		1-813-252-2625	7260				sfelver@beaconh.com	5415 Mariner St.	Suite 105	Tampa	FL	33609	12/30/2021	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Chief Financial Officer	VP of Accounting and Finance	Ms.	Donoghue	Patricia		1-336-790-4386					tdonoghue@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	03/02/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	CMS Casework Communication Contact	Director of Operations		Carter	Bethany		1-336-790-4359					bcarter@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	03/02/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Coordination of Benefits Contact		Ms.	Agosto	Christina		1-813-252-2625	7142				cagosto@beaconh.com	5415 Mariner St.	Suite 105	Tampa	FL	33609	02/04/2019	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Customer Service Operations Contact	Director of Operations	Ms.	Velez	Ashley		1-888-965-1965					avelez@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	03/02/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Government Relations Contact	VP of Compliance		Tran	Triet		1-307-250-2082					ttran@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	08/09/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Hospice Contact	Chief Pharmacy Officer	Dr.	Homer	Deanna		1-336-790-4385					dhomer@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	05/21/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Medicare Compliance Officer	VP of Compliance	Mr	Tran	Triet		1-307-250-2082					ttran@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	08/09/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Part D Exceptions Contact	Manager of Pharmacy PA Operations		Chakrabarti	Swapna						1-866-871-8565	swapna.chakrabarti@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active	1-800-237-1992				HMO - Health Maintenance Organization		C	Atlanta
H2624	Pharmacy Network Management Contact	Chief Administrative Officer		Wickremeratne	Aruna		1-508-804-6923				1-330-405-8094	aruna.w@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2624	Pharmacy Technical Help Desk Contact	VP of Consumer Services		Kota	Rupa							rupa.kota@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active	1-800-459-0984				HMO - Health Maintenance Organization		C	Atlanta
H2624	Plan to Plan Reconciliation Contact	VP of Accounting and Finance	Ms.	Donoghue	Patricia		1-336-790-4386					tdonoghue@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	03/02/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	HMO/HMOPOS		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-888-736-9118				1-888-554-7668	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/03/2018	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/22/2022	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/22/2022	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/22/2022	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H2663	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2663	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H2663	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	COVENTRY HEALTH CARE OF MISSOURI, INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2686	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H2686	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2686	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H2686	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2694	Automated TrOOP Balance Transfer Contact	Pharmacy Director		Wingerchuk	Caron		1-480-492-3852					caron.wingerchuk@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Best Available Evidence Contact	Pharmacy Director		Wingerchuk	Caron		1-480-492-3852					caron.wingerchuk@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Chief Financial Officer		Mr.	Lawless	Tom		1-608-509-1628					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/01/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	CMS Casework Communication Contact	Medical Director	Dr.	Lingisetty	Chandra		1-501-817-1428					chandra.lingisetty@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Coordination of Benefits Contact	VP of Finance		Texeria	Edward		1-617-665-7430					edward.texeria@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Customer Service Operations Contact	Director of Operations		Cunniffe	Tom		1-617-299-3367					Tom.Cunniffe@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/22/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Government Relations Contact	Senior Compliance Associate		Ohringer	Ned		1-617-665-7641					ned.ohringer@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Hospice Contact	Medical Director	Dr.	Lingisetty	Chandra		1-501-817-1428					chandra.lingisetty@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Price	John		1-215-880-6876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Part D Exceptions Contact	Manager		Bricker	Bryce							bryce.m.bricker@optum.com	2441 Warrenville Road		Lisle	IL	60532	11/05/2021	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active	1-612-632-6838				PPO - BBA		C	New York
H2694	Pharmacy Network Management Contact	Director		Ashby	JoLynn		1-763-732-6364					JAshby@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	11/05/2021	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2694	Pharmacy Technical Help Desk Contact	Manager		Summers	Todd							Todd.summers@optum.com	755 Research Parkway		Oklahoma City	OK	73104	05/05/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active	1-800-797-9791				PPO - BBA		C	New York
H2694	Plan to Plan Reconciliation Contact	VP of Finance		Texeria	Edward		1-617-665-7430					edward.texeria@eternalhealth.com	31 St. James Ave.	Suite 950,	Boston	MA	02116	07/15/2022	2023	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	New York
H2697	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H2697	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2697	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H2697	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Automated TrOOP Balance Transfer Contact	MHI- VP, Medicare Finance, CFO		Wilson	David	S	1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/16/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Chief Financial Officer	MHI- VP, Medicare Finance, CFO	Mrs.	Wilson	David	S	1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/16/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	02/13/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	02/13/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	02/13/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	Chicago
H2715	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2715	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H2715	Plan to Plan Reconciliation Contact	MHI- VP, Medicare Finance, CFO		Wilson	David	S	1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/16/2022	2023	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2722	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Best Available Evidence Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Chief Financial Officer	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	CMS Casework Communication Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Coordination of Benefits Contact	Medicare Enrollment Supervisor	Mrs.	Drake	Michele		1-318-998-3083					mdrake@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Customer Service Operations Contact	Director of Member Services	Mrs.	Trichel	Amy		1-318-998-2870					atrichel@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Government Relations Contact	Deputy General Counsel	Mrs.	Harvey	Korey		1-225-297-2762					korey.harvey@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Hospice Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/02/2020	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Part D Exceptions Contact	Director of Pharmacy	Mr.	Dearman	Clyde							cdearman@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-318-998-2710				HMO - Health Maintenance Organization		C	Dallas
H2722	Pharmacy Network Management Contact	Associate Director Pharmacy Network Management		Burdick	Tammy		1-920-221-4089					Tammy.Burdick@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	07/13/2020	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2722	Pharmacy Technical Help Desk Contact	Pharmacy Director	Mr.	Dearman	Clyde							cdearman@vhpla.com	130 DeSiard St Suite 300		monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-866-704-0109				HMO - Health Maintenance Organization		C	Dallas
H2722	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF ARKANSAS, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2737	Automated TrOOP Balance Transfer Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		1-413-233-3423				1-413-233-3423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	02/04/2021	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Best Available Evidence Contact	Medicare Program Manager	Ms.	Sepko	Amy		1-413-787-4000	3351			1-413-233-3351	asepko@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/06/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Chief Financial Officer	Chief Financial Officer	Ms.	Cohen	Lisa		1-413-233-3024					lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	08/26/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	CMS Casework Communication Contact	Complaints & Appeals Manager	Mr.	Farrell	James		1-413-233-3231				1-413-233-3231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	02/04/2021	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Coordination of Benefits Contact	Claims Analytics & Payment Policy Manager	Ms.	Shaw	Joanne		1-413-233-3444				1-413-233-3444	jshaw@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	02/04/2021	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Customer Service Operations Contact	Manager Member Services	Ms.	Armstrong	Carolyn		1-413-233-3301				1-413-233-3301	carmstrong@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	02/17/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Government Relations Contact	Medicare Program Manager	Ms.	Sepko	Amy		1-413-787-4000	3351			1-413-233-3351	asepko@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/06/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Hospice Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		1-413-233-3423				1-413-233-3423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	02/04/2021	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Medicare Compliance Officer	Director of Compliance	Ms	Tulloch	Charmalee		1-413-233-3566				1-413-233-3566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/27/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Part D Exceptions Contact	Manager, Prior Authorization		Mourad	Hala							hala.mourad@optum.com	2441 Warrenville Rd	Suite 400	Lisle	IL	60532	02/04/2021	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	1-630-328-5837				PPO - BBA		C	New York
H2737	Pharmacy Network Management Contact			Pham	Katie		1-817-846-9722					katie.pham@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	06/06/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2737	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Summers	Todd							todd.summers@optum.com	755 Research Parkway	Suite 300	Oklahoma City	OK	73104	02/04/2021	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	1-866-443-1095				PPO - BBA		C	New York
H2737	Plan to Plan Reconciliation Contact	Assistant Controller	Ms.	King	Katie		1-413-787-4000	3008				kking2@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	02/04/2021	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	New York
H2752	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	08/30/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	08/30/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	02/16/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H2752	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	02/16/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H2752	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	CIGNA HEALTHCARE OF CONNECTICUT INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2765	Automated TrOOP Balance Transfer Contact	Supervisor Enrollment & Eligibility	Ms.	Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/11/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Best Available Evidence Contact	Supervisor Membership Accounting		Black	Colby		1-503-265-5606					colby.black@modahealth.com	601 SW 2nd Avenue		Portland	OR	97204	04/01/2022	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Chief Financial Officer	CFO	Mr.	Evans	Dave		1-503-243-3952				1-503-948-5557	dave.evans@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/27/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	CMS Casework Communication Contact	Lead Appeals Coordinator	Ms.	Shattuck	Mica		1-503-412-4021				1-833-949-1888	mica.shattuck@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/11/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Coordination of Benefits Contact			Service	Customer		1-844-827-2355				1-855-466-7208	MedicalMedicare@yoursummithealth.com	PO Box 820070		Portland	OR	97282	04/19/2022	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Customer Service Operations Contact	Customer Service Manager	Ms.	Duncan	Colleen		1-503-765-3424					colleen.duncan@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/27/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Government Relations Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		1-503-952-5075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	01/27/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Hospice Contact	Rx Government Programs Analyst	Mr.	Beebe	Colin		1-503-412-4175	4175			1-833-949-1889	colin.beebe@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	06/04/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	McWhorter	Gary		1-503-952-5075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	01/27/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Part D Exceptions Contact	Pharmacy, Customer Service		Service	Customer						1-833-949-7889	PharmacyMedicare@modahealth.com	601 S.W. Second Ave.		Portland	OR	97204	01/27/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active	1-844-827-2355				HMO - Health Maintenance Organization		C	Seattle
H2765	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@navitus.com	361 Integrity Drive		Madison	WI	53717	03/31/2022	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2765	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/27/2021	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active	1-866-270-3877				HMO - Health Maintenance Organization		C	Seattle
H2765	Plan to Plan Reconciliation Contact	Lead Pharmacy Benefit Formulary Coordinator	Ms.	Brokaw	Katie		1-503-265-4771	4771				katie.brokaw@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/27/2020	2023	SUMMIT HEALTH PLAN, INC.	Local CCP	Summit Health Plan, Inc.	HMO/HMOPOS		Moda Partners, Inc.	226	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2775	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H2775	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2775	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H2775	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H2782	Automated TrOOP Balance Transfer Contact	Business Analyst - Systems Coord, Pharmacy	Ms.	Cintron	Alicia		1-503-574-8064				1-503-574-8646	alicia.cintron@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	12/09/2021	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Best Available Evidence Contact	Supervisor - Medicare Membership Accounting	Ms.	Hopkins	Chantel		1-503-574-5723				1-503-574-8646	chantel.hopkins@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	01/30/2020	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Chief Financial Officer	Chief Financial Officer	Ms	Ruecker	Mariette	D	1-916-690-3769				1-916-563-3182	r.ruecker@westernhealth.com	2349 Gateway Oaks Drive, Suite 100		Sacramento	CA	95833	12/23/2020	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	CMS Casework Communication Contact	Medicare Compliance Officer	Ms	Warshaw	Jessica	A	1-916-563-2234				1-916-563-3182	j.warshaw@westernhealth.com	2349 Gateway Oaks Drive, Suite 100		Sacramento	CA	95833	04/15/2021	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Coordination of Benefits Contact	Manager - OFT	Ms.	Dutson	Jessica		1-503-574-6034					Jessica.Dutson@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	12/23/2020	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Customer Service Operations Contact	Supervisor Serice Ops- Customer Service	Ms.	Aronson	Elizabeth		1-503-574-6589					Elizabeth.Aronson@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	12/23/2020	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Government Relations Contact	Medicare Compliance Officer	Ms	Warshaw	Jessica	A	1-916-563-2234				1-916-563-3182	j.warshaw@westernhealth.com	2349 Gateway Oaks Drive, Suite 100		Sacramento	CA	95833	04/15/2021	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Hospice Contact	Pharmacy Director	Ms	Biring	Kiran		1-916-563-2273				1-916-563-3182	k.biring@westernhealth.com	2349 Gateway Oaks Drive, Suite 100		Sacramento	CA	95833	04/06/2021	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Warshaw	Jessica	A	1-916-563-2234				1-916-563-3182	j.warshaw@westernhealth.com	2349 Gateway Oaks Drive, Suite 100		Sacramento	CA	95833	04/15/2021	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Part D Exceptions Contact	Director, Pharmacy	Dr.	Clark	James							James.Clark2@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	03/11/2022	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active	1-877-216-3644				HMO - Health Maintenance Organization		C	San Francisco
H2782	Pharmacy Network Management Contact	VP, Pharmacy	Dr.	Noonan-Harnsberger	Helen	M	1-503-574-5708				1-503-574-8646	Helen.Noonan-Harnsberger@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	12/23/2020	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2782	Pharmacy Technical Help Desk Contact	Pharmacy Director		Clark	James						1-800-249-7714	James.clark2@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	12/08/2022	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active	1-888-445-5518				HMO - Health Maintenance Organization		C	San Francisco
H2782	Plan to Plan Reconciliation Contact	Healthcare Data  Analyst	Ms.	Williams	Rachelle		1-503-574-6316					rachelle.williams@providence.org	2349 Gateway Oaks Drive, Suite 100		Sacramento	CA	95833	09/09/2021	2023	WESTERN HEALTH ADVANTAGE	Local CCP	Western Health Advantage	HMO/HMOPOS		Western Health Advantage	260	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Automated TrOOP Balance Transfer Contact	Clinical Pharmacist		Cho	Evelyn		1-626-727-0465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	12/23/2021	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Best Available Evidence Contact	Membership Manger Sr.		Munoz	Alicia		1-626-838-5100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Chief Financial Officer	Chief Financial Officer	Mrs.	Bindra	Meeta		1-626-838-5100	5155				Meeta.Bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	04/16/2020	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	CMS Casework Communication Contact	Compliance Officer	Ms	Ruiz	Erica		1-562-239-5675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Coordination of Benefits Contact	Membership Manger Sr.		Munoz	Alicia		1-626-838-5100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Customer Service Operations Contact	Membership Manger Sr.		Munoz	Alicia		1-626-838-5100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Government Relations Contact	Compliance Officer	Ms	Ruiz	Erica		1-562-239-5675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Hospice Contact	CEO	Dr	Bindra	Pavel		1-626-838-5110				1-626-521-6028	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Medicare Compliance Officer	Compliance Officer	Ms	Ruiz	Erica		1-562-239-5675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Part D Exceptions Contact	Clinical Pharmacist		Cho	Evelyn							evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	12/23/2021	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	1-833-667-3497				HMO - Health Maintenance Organization		C	San Francisco
H2793	Pharmacy Network Management Contact	CEO	Dr	Bindra	Pavel		1-626-838-5110				1-626-521-6028	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2793	Pharmacy Technical Help Desk Contact	Vice president Operations		Conn	Todd							tconn@elixirsolutions.com	2181 E. Aurora Road	Suite 201	Twinsburg	OH	44087	11/24/2020	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	1-833-667-3497				HMO - Health Maintenance Organization		C	San Francisco
H2793	Plan to Plan Reconciliation Contact	Controller	Mrs	Bindra	Meeta		1-626-838-5100	5155			1-626-521-6028	meeta.bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	10/26/2021	2023	IMPERIAL INSURANCE COMPANIES INC.	Local CCP	Imperial Insurance Companies, Inc	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/17/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/01/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H2802	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2802	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H2802	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2815	Automated TrOOP Balance Transfer Contact	Business Office Manager		Cox	Terra		1-970-508-7737				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/18/2022	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	Best Available Evidence Contact	Executive Director		Howell	Keith		1-970-964-3500				1-970-252-0166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	03/04/2021	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	Chief Financial Officer	VP of Financial Services	Ms	Gavin	Nancy		1-612-428-7840				1-952-941-0428	ngavin@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	CMS Casework Communication Contact	Executive Director		Howell	Keith		1-970-964-3500				1-970-252-0166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	03/04/2021	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	Coordination of Benefits Contact	Business Office Manager		Cox	Terra		1-970-964-3556				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/18/2022	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	Customer Service Operations Contact	Executive Director		Howell	Keith		1-970-964-3500				1-970-252-0166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	03/04/2021	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	Government Relations Contact	Executive Director		Howell	Keith		1-970-964-3504				1-970-252-0166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	12/30/2020	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	Medicare Compliance Officer	Director of Program Integrity/Compliance	Ms	Linnell	Kathryn	R	1-970-508-7757				1-866-829-9949	klinnell@voa.org	2377 Robins Way		Montrose	CO	81401	09/09/2021	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	Part D Exceptions Contact	Business Manager		Cox	Terra						1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/18/2022	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active	1-970-508-7737				PACE - Nat		C	Denver
H2815	Pharmacy Network Management Contact	Executive Director		Howell	Keith		1-970-964-3500				1-970-252-0166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	03/04/2021	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2815	Pharmacy Technical Help Desk Contact	Executive Director		Howell	Keith						1-970-252-0166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	03/04/2021	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active	1-970-964-3500				PACE - Nat		C	Denver
H2815	Plan to Plan Reconciliation Contact	Business Office Manager		Cox	Terra		1-970-508-7737				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/18/2022	2023	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Denver
H2816	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/14/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	1-813-206-7152				PFFS - Private Fee for Service		C	Dallas
H2816	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2816	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	1-855-538-0454				PFFS - Private Fee for Service		C	Dallas
H2816	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H2825	Automated TrOOP Balance Transfer Contact	Enrollment, Eligibility and OHI Director		Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/16/2022	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Best Available Evidence Contact	Enrollment, Eligibility and OHI Director		Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/16/2022	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Chief Financial Officer	CFO	Mr.	Barden	Sean		1-540-741-1414					sean.barden@mwhc.com	1001 Sam Perry Boulevard	Executive Offices	Fredericksburg	VA	22401	02/06/2019	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	CMS Casework Communication Contact	Compliance Officer	Ms.	Blalock	Lauren		1-540-741-2459					lauren.blalock@mwhc.com	2300 Fall Hill Ave.	Suite 509	Fredericksburg	VA	22401	10/23/2019	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Coordination of Benefits Contact			Inquiries	COB		1-844-529-3760					COBInquiry@lumeris.com	P O BOX 7118		Troy	MI	48007	12/16/2022	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoeffer	Linda		1-636-686-9682					rmeyerhoeffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/26/2021	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Government Relations Contact	COO	Mr.	Turner	Travis		1-540-741-2248					travis.turner@mwhc.com	2300 Fall Hill Ave.	Suite 308B	Fredericksburg	VA	22401	07/13/2020	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Hospice Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/04/2019	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Medicare Compliance Officer	Compliance Officer	Ms.	Blalock	Lauren		1-540-741-2459					lauren.blalock@mwhc.com	2300 Fall Hill Ave.	Suite 509	Fredericksburg	VA	22401	10/23/2019	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian							brian_schumm@express-scripts.com	5151 Blazer Parkway		Dublin	OH	43017	07/15/2022	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	Philadelphia
H2825	Pharmacy Network Management Contact	Ntwk Acct Director, Retail Strategy & Contracting	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		Saint Louis	MO	63121	10/05/2020	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2825	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Monroe	LaTasha							latasha_monroe@express-scripts.com	13051 North Telecom Pkwy	Suite 150	Temple Terrace	FL	33637	11/29/2021	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Philadelphia
H2825	Plan to Plan Reconciliation Contact	Manager, Client Payments	Ms.	Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/26/2021	2023	MARY WASHINGTON HEALTH PLAN	Local CCP	Mary Washington Medicare Advantage	HMO/HMOPOS		Mary Washington Healthcare	737	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2835	Automated TrOOP Balance Transfer Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		1-734-879-0325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Best Available Evidence Contact	Executive Director	Ms	Decker	Susan		1-517-768-9791					sdecker@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Chief Financial Officer	PACE Director of Finance	Ms	Dukes	Jaclyn		1-734-755-3190					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	CMS Casework Communication Contact	Director of Quality	Ms	Gibbs	Sandy		1-517-768-9791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Coordination of Benefits Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		1-734-879-0325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Customer Service Operations Contact	Quality Manager	Ms	Gibbs	Sandy		1-517-768-9791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	12/12/2016	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Government Relations Contact	Executive Director	Ms	Decker	Susan		1-517-768-9791					sdecker@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Medicare Compliance Officer	Director of Quality	Ms	Gibbs	Sandy		1-517-768-9791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Part D Exceptions Contact	Medical Director	Dr.	Foust	Michael	A						mfoust@thomepace.org	2282 Springport Road		Jackson	MI	49202	02/17/2022	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active	1-844-855-7223				PACE - Nat		C	Chicago
H2835	Pharmacy Network Management Contact	Executive Director	Ms	Decker	Susan		1-517-768-9791					sdecker@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Pharmacy Technical Help Desk Contact	Pharmacist		Schloemer	Rosalyn							rschloemer@thomepace.org	Thome PACE	2282 Springport Road	Jackson	MI	49202	12/09/2020	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active	1-844-855-7223				PACE - Nat		C	Chicago
H2835	Plan to Plan Reconciliation Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		1-734-879-0325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2023	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2836	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H2836	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2836	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H2836	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2853	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	01/31/2020	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H2853	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2853	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H2853	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2879	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H2879	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2879	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H2879	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF WISCONSIN, INC.	Local CCP	Molina Healthcare of Wisconsin and Massachusetts	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2882	Automated TrOOP Balance Transfer Contact	Business Office Manager	Ms	LaVigne	Ashley		1-989-953-5828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	08/20/2020	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	Best Available Evidence Contact	Quality Manager	Ms	Reeves	Brenda		1-989-953-5810					bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	11/03/2020	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	Chief Financial Officer	Chief Financial Officer	Mr	Moeggenborg	Todd		1-989-466-3824				1-989-466-2796	tmoeggenborg@masonicpathways.com	1200 Wright Avenue		Alma	MI	48801	07/07/2021	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	CMS Casework Communication Contact	Quality Manager	Ms	Reeves	Brenda		1-989-953-5810				1-989-953-5801	bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	08/16/2021	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	Coordination of Benefits Contact	Community Liasion		Faber	Krista		1-989-953-5813				1-989-953-5801	kkfaber@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	02/16/2022	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	Customer Service Operations Contact	Executive Director	Ms	Altom	Dayna		1-989-953-5805					daltom@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	08/20/2020	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	Government Relations Contact	Executive Director	Ms	Altom	Dayna		1-989-953-5805				1-989-953-5801	daltom@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	03/10/2020	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	Medicare Compliance Officer	Quality Manager	Ms	Reeves	Brenda		1-989-953-5810				1-989-953-5802	bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	01/12/2021	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	Part D Exceptions Contact	Business Office Manager	Ms	LaVigne	Ashley							alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	08/20/2020	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active	1-989-953-5828				PACE - Nat		C	Chicago
H2882	Pharmacy Network Management Contact	Executive Director	Ms	Altom	Dayna		1-989-953-5805					daltom@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	03/10/2020	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2882	Pharmacy Technical Help Desk Contact	Pharmacist	Mr	Le	Viet							viet@kltcpharmacy.com	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active	1-269-598-4000				PACE - Nat		C	Chicago
H2882	Plan to Plan Reconciliation Contact	Business Office Manager	Mr	LaVigne	Ashley		1-989-953-5828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	08/20/2020	2023	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Chicago
H2915	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H2915	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2915	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H2915	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2923	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H2923	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2923	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H2923	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2926	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Ehlert	Ann		1-320-759-4154				1-320-762-5945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Best Available Evidence Contact	Manager of Enrollment	Ms.	Jirik	Becky		1-320-335-5219				1-320-335-5223	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	04/02/2018	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Chief Financial Officer	Chief Financial Officer	Mr.	Tava	Alex		1-651-389-4570				1-651-228-9893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500,	St. Paul	MN	55101	10/24/2019	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	CMS Casework Communication Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		1-320-335-5392				1-320-762-8750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Coordination of Benefits Contact	Manager of Enrollment	Ms.	Jirik	Becky		1-320-335-5219				1-320-335-5223	MedicareCOB@primewest.org	PrimeWest Health	3905 Dakota Street	Alexandria	MN	56309	04/12/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Customer Service Operations Contact	Director of Membership & Program Development	Mr.	Magnuson	Matt		1-320-335-5243				1-320-335-5223	matt.magnuson@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Government Relations Contact	Chief Executive Officer	Mr.	Przybilla	James		1-320-335-5250				1-320-335-5339	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Hospice Contact	Director of Pharmacy	Ms.	Ehlert	Ann		1-320-759-4154				1-320-762-5945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota Street	Alexandria	MN	56308	09/15/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Medicare Compliance Officer	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		1-320-335-5399				1-320-762-5937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Part D Exceptions Contact	Director of Pharmacy	Ms.	Ehlert	Ann						1-320-762-5945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	1-320-759-4154				HMO - Health Maintenance Organization		C	Chicago
H2926	Pharmacy Network Management Contact	Dir Pharmacy Network Administration	Mr.	Hunt	Brian		1-858-790-7092					Brian.Hunt@MedImpact.com	MedImpact HealthCare Systems Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	12/13/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2926	Pharmacy Technical Help Desk Contact	Director Customer Contact Services	Ms.	Brewer	Kathy							customerservice@medimpact.com	MedImpact HealthCare Systems, Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	06/17/2022	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	1-877-391-9294				HMO - Health Maintenance Organization		C	Chicago
H2926	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Tava	Alex		1-651-389-4570				1-651-228-9893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2023	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2936	Automated TrOOP Balance Transfer Contact	Finance Manager	Ms.	Murar	Ann		1-616-378-6469				1-616-949-7886	amurar@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	04/15/2022	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	Best Available Evidence Contact	Executive Director	Ms.	Gras	Heidi		1-616-582-3111				1-231-332-8600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	Chief Financial Officer	Finance Manager	Ms.	Murar	Ann		1-616-378-6469				1-616-949-7886	amurar@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	04/15/2022	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	CMS Casework Communication Contact	Executive Director	Ms.	Gras	Heidi		1-616-582-3111				1-231-733-8683	hgras@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	12/28/2021	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	Coordination of Benefits Contact	Strategic Director Health Plan Operations	Ms.	Gras	Heidi		1-616-582-3111				1-616-582-3149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	01/08/2021	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	Customer Service Operations Contact	Executive Director	Ms.	Gras	Heidi		1-616-582-3111				1-231-332-8600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	Government Relations Contact	Executive Director	Ms.	Gras	Heidi		1-616-582-3111				1-231-332-8600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	Medicare Compliance Officer	Program Integrity Manager	Ms.	Whitney	Erin		1-616-483-6825				1-231-332-8600	ewhitney@lifecircles-pace.org	12330 James St.		Holland	MI	49424	12/28/2021	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	Part D Exceptions Contact	Finance Manager	Ms.	Murar	Ann						1-616-949-7886	amurar@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	04/15/2022	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active	1-231-733-8650				PACE - Nat		C	Chicago
H2936	Pharmacy Network Management Contact			Gras	Heidi		1-616-582-3111				1-616-582-3149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	01/08/2021	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2936	Pharmacy Technical Help Desk Contact			Gras	Heidi						1-616-582-3149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	01/08/2021	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active	1-616-582-3111				PACE - Nat		C	Chicago
H2936	Plan to Plan Reconciliation Contact	Finance Manager	Ms.	Murar	Ann		1-616-378-6469				1-616-949-7886	amurar@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	04/15/2022	2023	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Chicago
H2937	Automated TrOOP Balance Transfer Contact	NA	Mr.	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Best Available Evidence Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Chief Financial Officer	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	CMS Casework Communication Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Coordination of Benefits Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Customer Service Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Government Relations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Medicare Compliance Officer	Executive Director	Ms	Guty	Genene		1-724-838-8300					GGuty@seniorlifegreensburg.com	123 Triangle Drive		Greensburg	PA	15601	10/08/2019	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Part D Exceptions Contact	Chief Financial Officer	Mr	Dodson	David						1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active	1-814-535-6000	22102			PACE - Nat		C	Philadelphia
H2937	Pharmacy Network Management Contact			Rowland	Bob		1-724-275-1203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Pharmacy Technical Help Desk Contact			Rowland	Bob							Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active	1-724-275-1203	219			PACE - Nat		C	Philadelphia
H2937	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Automated TrOOP Balance Transfer Contact	Finance Manager	Mrs.	Brennaman	Courtney		1-757-553-3105				1-757-382-4957	crbrenna@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Best Available Evidence Contact	Program Director	Mrs.	Ford	Merinda		1-757-553-3105				1-757-382-4957	mbford2@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Chief Financial Officer	Finance Manager	Mrs.	Brennaman	Courtney		1-757-252-7800				1-757-382-4957	crbrenna@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	12/21/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	CMS Casework Communication Contact	Program Director	Mrs.	Ford	Merinda		1-757-553-3105				1-757-382-4957	mbford2@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Coordination of Benefits Contact	Business Office Specialist	Mrs.	Earl	Adrian		1-757-553-3105				1-757-382-4957	atpace@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/24/2022	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Customer Service Operations Contact	Program Director	Mrs.	Ford	Merinda		1-757-553-3105				1-757-382-4957	mbford2@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Government Relations Contact	Program Director	Mrs.	Ford	Merinda		1-757-553-3105				1-757-382-4957	mbford2@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Medicare Compliance Officer	Program Director	Mrs.	Ford	Merinda		1-757-553-3105				1-757-382-4957	mbford2@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Part D Exceptions Contact	Finance Manager	Mrs.	Brennaman	Courtney						1-757-382-4957	crbrenna@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active	1-757-553-3105				PACE - Nat		C	Philadelphia
H2941	Pharmacy Network Management Contact	Finance Manager	Mrs.	Brennaman	Courtney		1-757-553-3105				1-757-382-4957	crbrenna@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Pharmacy Technical Help Desk Contact	Manager, Pharmacy		Lee	Doug						1-757-388-4018	dhlee@sentara.com	600 Gresham Drive		Norfolk	VA	23507	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active	1-757-388-0347				PACE - Nat		C	Philadelphia
H2941	Plan to Plan Reconciliation Contact	Finance Manager	Mrs.	Brennaman	Courtney		1-757-553-3105				1-757-382-4957	crbrenna@sentara.com	535 Independence Parkway	Suite 100	Chesapeake	VA	23320	05/26/2021	2023	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2942	Automated TrOOP Balance Transfer Contact	VP of Sales		Stead	Bart		1-417-269-2843				1-417-269-2949	bstead@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Best Available Evidence Contact	Director of Govt Programs		Hammond	Kaitlyn		1-417-269-2728				1-417-269-2919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Chief Financial Officer	CFO	Mrs.	Odom	Lisa		1-417-269-2885					lodom@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	CMS Casework Communication Contact	Grievance and Subrogation Coordinator		Mathis	Earlisha		1-417-269-2905				1-417-269-2949	emathis@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	12/15/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Coordination of Benefits Contact	CIO		Butts	Susan	M	1-417-269-2968				1-417-269-2848	sbutts@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	04/12/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Customer Service Operations Contact	VP of Health Services		O'Connell	Daniel		1-417-269-2966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Government Relations Contact	Director of Govt Programs		Hammond	Kaitlyn		1-417-269-2728				1-417-269-2919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Hospice Contact	VP of Health Services		O'Connell	Daniel		1-417-269-2966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Medicare Compliance Officer	Director of Govt Programs	Mrs.	Hammond	Kaitlyn		1-417-269-2827					khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Part D Exceptions Contact			O'Connell	Daniel							doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	02/10/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active	1-800-664-1244				HMO - Health Maintenance Organization		C	Kansas City
H2942	Pharmacy Network Management Contact	VP of Health Services		O'Connell	Daniel		1-417-269-2966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Pharmacy Technical Help Desk Contact			O'Connell	Daniel								PO Box 5750		Springfield	MO	65801	02/10/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active	1-800-664-1244				HMO - Health Maintenance Organization		C	Kansas City
H2942	Plan to Plan Reconciliation Contact	CFO	Mrs.	Odom	Lisa		1-417-269-2885					lodom@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2023	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2944	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	1-502-580-9138				PFFS - Private Fee for Service		C	Kansas City
H2944	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2944	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	1-800-865-8715				PFFS - Private Fee for Service		C	Kansas City
H2944	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H2960	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		1-858-790-6250					partdcat@medimpact.com	MedImpact	10181 Scripps Gateway Ct.	San Diego	CA	92131	12/31/2019	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Best Available Evidence Contact	Manager of Revenue_Enrollment Servics	Ms	Foote	Tammi		1-775-982-3186					Tammi.Foote@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Chief Financial Officer	Chief Financial Officer	Mr.	Coffin	Bill		1-775-982-1163					William.Coffin@renown.org	10315 Professional Circle		Reno	NV	89521	09/13/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	CMS Casework Communication Contact	Compliance Manger	Ms	Linzey	Lenee		1-775-982-3025					Lenee.Linzey@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Coordination of Benefits Contact	COB_Subrogation Specialist Services	Ms	Wold	Patricia		1-775-982-3225					Patricia.Wold@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Customer Service Operations Contact	Manager of Contact Center	Ms	Garcia	Nallely		1-775-982-2661				1-775-982-3748	nallely.garcia@renown.org	10315 Professional Circle		Reno	NV	89502	11/30/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Government Relations Contact	Senior Director of Government Programs	Mr	Bawden	CJ		1-775-982-3218				1-775-982-3743	CJ.bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Hospice Contact	Director of Pharmacy	Ms	Gouchenour	Christie		1-775-982-3085					christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Medicare Compliance Officer	Compliance Manager	Ms	Linzey	Lenee		1-775-982-3025					Lenee.Linzey@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	09/24/2020	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Part D Exceptions Contact	Director of Pharmacy	Ms	Gouchenour	Christie							christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active	1-775-982-3085				HMO - Health Maintenance Organization		C	Dallas
H2960	Pharmacy Network Management Contact	Manager, Pharmacy Network Support & Drug Data Mgt		Robertson	Jeanine		1-858-790-6108					jeanine.robertson@medimpact.com	MedImpact	10181 Scripps Gateway Ct.	San Diego	CA	92131	12/11/2019	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Pharmacy Technical Help Desk Contact	Director, Corporate Development		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/17/2020	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active	1-800-681-9585				HMO - Health Maintenance Organization		C	Dallas
H2960	Plan to Plan Reconciliation Contact	Senior Financial Analyst	Mr	Wingfield	Joseph		1-775-982-3190					Joseph.Wingfield@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2023	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2962	Automated TrOOP Balance Transfer Contact	CFO	Mr.	Maszak	Edward		1-352-515-5930				1-352-835-7169	eMaszak@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	05/18/2020	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Best Available Evidence Contact	COO	Mrs	Debi	Darilu		1-352-515-5912				1-352-835-7169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	07/17/2017	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Chief Financial Officer	CFO	Mr.	Maszak	Edward		1-352-515-5930				1-352-835-7169	eMaszak@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	01/06/2021	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	CMS Casework Communication Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		1-352-835-7151	6408			1-352-835-7169	npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	10/20/2022	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Coordination of Benefits Contact	COO	Ms.	Debi	Darilu		1-352-515-5912				1-352-835-7169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	05/12/2016	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Customer Service Operations Contact	COO	Mrs	Debi	Darilu		1-352-515-5912				1-352-835-7169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/18/2019	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Government Relations Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		1-352-835-7151	6408			1-352-835-7169	npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	10/20/2022	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Hospice Contact	Chief Medical Director	Dr.	Shah	Pragnesh		1-352-515-5954				1-352-835-7169	pshah@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	11/12/2020	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patel	Nirali		1-352-835-7151	6408			1-352-835-7169	npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	10/20/2022	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Part D Exceptions Contact	Manager, Prior Authorization		Bricker	Bryce							bryce.m.bricker@optum.com	9040 S. Rita Rd		Tucson	AZ	85747	01/11/2021	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	1-612-632-6838				HMO - Health Maintenance Organization		C	Atlanta
H2962	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	01/05/2021	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2962	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							todd.summer@optum.com	1000 Optum Cir.		Eden Prairie	MN	55344	12/16/2022	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	1-800-311-7517				HMO - Health Maintenance Organization		C	Atlanta
H2962	Plan to Plan Reconciliation Contact	CFO	Mr.	Maszak	Edward		1-352-515-5930				1-352-835-7169	eMaszak@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/11/2020	2023	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2986	Automated TrOOP Balance Transfer Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					enrollment@lumeris.com	13900 Riverport Dr		Maryland Heights	MO	63043	12/08/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Best Available Evidence Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/08/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Chief Financial Officer	Chief Financial Officer	Mr.	Grabski	Ben		1-763-300-7611					bgrabski@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	CMS Casework Communication Contact	Sr. Director Compliance	Mr.	Whitbeck	Britton		1-314-209-3989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/07/2022	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Coordination of Benefits Contact			Inquiries	COB		1-855-996-8422					COBInquiry@lumeris.com	P O BOX 5904		TROY	MI	48007	12/06/2022	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoffer	Linda		1-636-683-9682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/05/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		1-314-209-2717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/05/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Hospice Contact	Director, Pharmacy		Cruz	Jennifer		1-314-770-3556					pharmacy@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/05/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Medicare Compliance Officer	VP Internal Audit and Chief Compliance Officer	Ms.	Venable	Erin		1-314-209-3957					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/05/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Part D Exceptions Contact		Ms.	Byers	June							June.Byers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/05/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				HMO - Health Maintenance Organization		C	Kansas City
H2986	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/05/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2986	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/16/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	1-800-243-2051				HMO - Health Maintenance Organization		C	Kansas City
H2986	Plan to Plan Reconciliation Contact	Manager, Client Payments		Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	04/06/2021	2023	Essence Healthcare of California, Inc.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2992	Automated TrOOP Balance Transfer Contact	NA	Mr.	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Best Available Evidence Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Chief Financial Officer	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	CMS Casework Communication Contact	Cheif Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Coordination of Benefits Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Customer Service Operations Contact	Cheif Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Government Relations Contact	Cheif Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Medicare Compliance Officer	Executive Director	Ms	Detwiler	Megan		1-724-222-5433	101			1-814-248-7902	SLWDirectors@seniorlifewashington.com	2114 North Franklin Drive		Washington	PA	15301	08/19/2019	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Part D Exceptions Contact	Chief Financial Officer	Mr	Dodson	David						1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active	1-814-535-6000	22102			PACE - Nat		C	Philadelphia
H2992	Pharmacy Network Management Contact			Rowland	Bob		1-724-275-1203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Pharmacy Technical Help Desk Contact			Rowland	Bob							Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active	1-724-275-1203	219			PACE - Nat		C	Philadelphia
H2992	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H3015	Automated TrOOP Balance Transfer Contact	Advisor Business CVS		Davis	Brittany		1-480-606-4613					FIRSupport@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/21/2021	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Best Available Evidence Contact	VP Internal Operations		Purcell	Tracy		1-629-204-6740					Tracy_Purcell@Sharedhealth.com	2501 McGavock Pike Suite 600		Nashville	TN	37214	12/15/2022	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Chief Financial Officer	CFO	Mr	Giblin	John		1-423-535-4884					john_giblin@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/09/2022	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	CMS Casework Communication Contact	Clinical Management		Pugh	Donna		1-423-535-6563					Donna_Pugh@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/15/2022	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Coordination of Benefits Contact	Manger Revenue Reconciliation		Camp	Jan		1-423-535-3639					jan_camp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/20/2022	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Customer Service Operations Contact	VP External Operations		Boswell	Brooke		1-629-204-6709					Brooke_Boswell@Sharedhealth.com	2501 McGavock Pike	Suite 600	Nashville	TN	37214	01/22/2020	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Government Relations Contact	Medicare Compliance Officer	Ms.	Womble	Charriet		1-615-347-9580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Hospice Contact	VP Internal Operations		Purcell	Tracy		1-629-204-6740					Tracy_Purcell@Sharedhealth.com	2501 McGavock Pike	Suite 600	Nashville	TN	37214	01/22/2020	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Medicare Compliance Officer	Medicare Compliance Officer	Mrs	Womble	Charriet		1-615-347-9580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Part D Exceptions Contact	Manager Coverage Reviews 1		Moss	Portia							Portia_Moss@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/10/2019	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	1-800-831-2583				HMO - Health Maintenance Organization		C	Atlanta
H3015	Pharmacy Network Management Contact	Advisor Network Products CVS		Lowe	David		1-480-744-9231				1-877-387-5800	David.Lowe2@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/20/2021	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3015	Pharmacy Technical Help Desk Contact	Vendor Management		Horton	Kasena							Kasena.Horton@CVSHealth.com	2401 Cherahala  Blvd		Knoxville	TN	37932	12/21/2021	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Atlanta
H3015	Plan to Plan Reconciliation Contact	Business Analyst Associate		Stinnett	James		1-423-535-1624					P2PAdministration_GM@bcbst.com	Attn: P2P Coordinator	1 Cameron Hill Circle Suite 0050	Chattanooga	TN	37402-0050	12/10/2019	2023	SHARED HEALTH MISSISSIPPI, INC.	Local CCP	Shared Health Dual Plus	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3041	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H3041	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3041	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H3041	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3047	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H3047	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3047	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H3047	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3060	Automated TrOOP Balance Transfer Contact	Director Financial Management	Mr.	Hamm	David		1-724-776-1100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/23/2022	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Best Available Evidence Contact	Director of Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Chief Financial Officer	CFO	Mr.	Carraway	Jeffrey		1-724-776-1100					jeffrey.carraway@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	02/02/2018	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	CMS Casework Communication Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Coordination of Benefits Contact	Director of Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Customer Service Operations Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Government Relations Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Medicare Compliance Officer	Director of Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part D Exceptions Contact	Director of Financial Management	Mr.	Hamm	David							dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active	1-724-742-2226				PACE - Nat		C	Philadelphia
H3060	Pharmacy Network Management Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Hanna	Abeer							abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	04/21/2017	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active	1-724-287-5433				PACE - Nat		C	Philadelphia
H3060	Plan to Plan Reconciliation Contact	Director of Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2023	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3069	Automated TrOOP Balance Transfer Contact	CFO		Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Best Available Evidence Contact	CFO		Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Chief Financial Officer	CFO	Mr.	Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	CMS Casework Communication Contact			Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Coordination of Benefits Contact			Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Customer Service Operations Contact			Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Government Relations Contact			Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Medicare Compliance Officer	CFO	Mr.	Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Part D Exceptions Contact			Fernandez	Alexander							amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending	1-954-473-7483				PACE - Nat		C	Atlanta
H3069	Pharmacy Network Management Contact			Lacknauth	Dave		1-954-473-7078					dlacknauth@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Pharmacy Technical Help Desk Contact			Lacknauth	Dave							dlacknauth@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending	1-954-473-7078				PACE - Nat		C	Atlanta
H3069	Plan to Plan Reconciliation Contact	CFO		Fernandez	Alexander		1-954-473-7483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2023	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3071	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-614-336-3326				HMO - Health Maintenance Organization		C	Chicago
H3071	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3071	Pharmacy Technical Help Desk Contact			Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	08/04/2021	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H3071	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3080	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H3080	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3080	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H3080	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3084	Automated TrOOP Balance Transfer Contact	Healthy Aging & Wellness Program Director		Wong	Heidi		1-206-462-7189					heidiw@ichs.com	PO Box 3007		Seattle	WA	98114	11/17/2022	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	Best Available Evidence Contact	Healthy Aging & Wellness Program Director		Wong	Heidi		1-206-462-7189					heidiw@ichs.com	PO Box 3007		Seattle	WA	98114	11/17/2022	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	Chief Financial Officer	Chief Financial Officer	Mr.	Shahbazian	Hermes		1-206-788-3618					2hermes@ichs.com	720 8th Ave South		Seattle	WA	98104	12/19/2017	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	CMS Casework Communication Contact	PACE Center Manager		He	Raymond		1-206-462-7188					raymondh@ichs.com	PO Box 3007		Seattle	WA	98114	07/02/2021	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	Coordination of Benefits Contact	Healthy Aging & Wellness Program Director		Wong	Heidi		1-206-462-7189					heidiw@ichs.com	PO Box 3007		Seattle	WA	98114	11/17/2022	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	Customer Service Operations Contact	Healthy Aging & Wellness Program Director		Wong	Heidi		1-206-462-7189					heidiw@ichs.com	PO Box 3007		Seattle	WA	98114	11/17/2022	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	Government Relations Contact	CEO & President		Batayola	Teresita		1-206-788-3656					teresitab@ichs.com	720 8th Ave South		Seattle	WA	98104	09/23/2020	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	Medicare Compliance Officer	HAWP Compliance Officer	Ms.	Schippa	Amie		1-206-788-3700					amies@ichs.com	PO Box 3007		Seattle	WA	98114	05/24/2021	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	Part D Exceptions Contact	HAWP Director		Wong	Heidi							heidiw@ichs.com	803 S. Lane St		Seattle	WA	98104	11/17/2022	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active	1-206-462-7189				PACE - Nat		C	Seattle
H3084	Pharmacy Network Management Contact	HAWP Director	Mr.	Wong	Heidi		1-206-462-7189					heidiw@ichs.com	803 S. Lane St		Seattle	WA	98104	11/17/2022	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3084	Pharmacy Technical Help Desk Contact	HAWP Director		Wong	Heidi							heidiw@ichs.com	803 S. Lane St		Seattle	WA	98104	11/17/2022	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active	1-206-462-7189				PACE - Nat		C	Seattle
H3084	Plan to Plan Reconciliation Contact	Chief Financial Officer		Shahbazian	Hermes		1-206-788-3618					2hermes@ichs.com	720 8th Ave South		Seattle	WA	98104	12/19/2017	2023	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	Seattle
H3113	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/17/2020	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H3113	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3113	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H3113	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager	Mr.	Zlotkus	Steve		1-858-790-6250					partdcat@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/16/2019	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Best Available Evidence Contact	Health Plan Administrator	Mr.	O'Malley	Michael		1-323-337-9172				1-888-235-8482	michael.omalley@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Chief Financial Officer	Chief Financial Officer	Mr.	Honig Mojica	Lyle		1-323-860-5244				1-323-962-8513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	03/14/2022	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	CMS Casework Communication Contact	Risk Manager, Grievance & Appeals	Ms.	Beneche	Emelyne		1-954-522-3132	53292			1-888-965-7430	emelyne.beneche@aidshealth.org	700 SE 3rd Ave, 4th Floor		Fort Lauderdale	FL	33316	04/28/2022	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Coordination of Benefits Contact	Health Plan Administrator	Mr.	O'Malley	Michael		1-323-337-9172				1-888-235-8482	michael.omalley@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Customer Service Operations Contact	Health Plan Administrator	Mr.	O'Malley	Michael		1-888-456-4715				1-888-235-8482	michael.omalley@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Government Relations Contact	Chief of Managed Care	Ms.	Stidham	Donna	M	1-805-660-0703				1-323-337-9141	donna.stidham@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Hospice Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		1-323-436-5005				1-888-238-2244	anthony.dao@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Medicare Compliance Officer	Compliance Officer	Ms.	Holzner	Sandra		1-323-337-9153					sandra.holzner@ahf.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	01/11/2022	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Part D Exceptions Contact	Pharmacy Director - Managed care	Mr.	Dao	Anthony						1-888-238-2244	anthony.dao@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	1-888-554-1334				HMO - Health Maintenance Organization		C	San Francisco
H3132	Pharmacy Network Management Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		1-323-436-5005				1-888-238-2244	anthony.dao@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3132	Pharmacy Technical Help Desk Contact	Pharmacy Director - Managed care	Mr.	Dao	Anthony						1-888-238-2244	anthony.dao@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	1-888-554-1334				HMO - Health Maintenance Organization		C	San Francisco
H3132	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Honig Mojica	Lyle		1-323-860-5244				1-323-860-5283	lyle.honig@aidshealth.org	6255 W. Sunset Blvd., 21st Floor		Los Angeles	CA	90028	03/14/2022	2023	AHF MCO OF FLORIDA, INC.	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3146	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/07/2018	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/06/2019	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/22/2022	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/22/2022	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/22/2022	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3146	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3146	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3146	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/22/2022	2023	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3152	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3152	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3152	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3170	Automated TrOOP Balance Transfer Contact	Manager PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755					EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/16/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Best Available Evidence Contact	Enrollment and Billing Manager	Ms.	Ware	Anita		1-508-330-9500					Anita.Ware@advantasure.com	134 Turnpike Road		Southborough	MA	01772	02/08/2019	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Chief Financial Officer	VP Actuarial, Underwriting & Data Analytics	Mr	Konnath	Steven		1-402-982-8862					Steven.Konnath@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/16/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	CMS Casework Communication Contact	Client Relations Compliance Consultant	Ms.	Leon	Megan		1-248-665-4675					mleon@bcbsm.com	600 Lafayette East	TC1301	Detroit	MI	48226	02/16/2021	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Coordination of Benefits Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755					COBMedD@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/16/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Customer Service Operations Contact	Director, Workforce Management, Analytics & Suppor		Weber	Julie		1-888-505-2022					jweber@bcbsm.com	500 Lafayette East		Detroit	MI	48226	04/19/2021	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Government Relations Contact	Chief Actuary and Analytics Officer	Mr.	Konnath	Steven		1-402-982-8862					steven.konnath@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	12/19/2022	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Hospice Contact	Pharmacy Program Manager	Mr.	Keiser	Michael		1-402-982-7700					Michael.Keiser@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	03/25/2019	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Medicare Compliance Officer	MA Compliance Officer	Ms.	Vaughn	Shannon		1-402-982-7846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	06/18/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/29/2021	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active	1-800-693-6703				HMO - Health Maintenance Organization		C	Kansas City
H3170	Pharmacy Network Management Contact	AVP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/29/2021	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3170	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/29/2021	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active	1-855-457-1351				HMO - Health Maintenance Organization		C	Kansas City
H3170	Plan to Plan Reconciliation Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		1-402-982-8790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3186	Automated TrOOP Balance Transfer Contact	Senior Director of Government Programs	Ms.	Fuller	Rebecca		1-605-328-7007					rebecca.fuller@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Best Available Evidence Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Chief Financial Officer	Vice President of Finance	Mr.	Maude	Brian		1-605-328-6801					Brian.Maude@SanfordHealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	CMS Casework Communication Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		1-605-328-7182					aleesa.jansick@sanfordhealth.org	300 Cherapa place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Coordination of Benefits Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Customer Service Operations Contact	Director of Customer Service	Mr.	Ling	Ryan		1-605-312-7459					ryan.ling@sanfordhealth.org	300 N Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Government Relations Contact	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Hospice Contact	Director of Utilization Management	Ms.	Kanta	Misty		1-605-312-2788					misty.kanta@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Exceptions Contact	Manager, Prior Authorization	Ms.	Le	Christina						1-877-239-4565	rxsol_prior_auth_redirected_queue_DL@uhc.com	3515 Harbor Blvd		Costa Mesa	CA	92626	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active	1-888-403-3398				PPO - BBA		C	Dallas
H3186	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway	Suite 200	Schaumburg	IL	60173-6801	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active	1-844-642-9090				PPO - BBA		C	Dallas
H3186	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		1-605-312-9344					debora.harris@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Sanford Health Plan of Minnesota	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3189	Automated TrOOP Balance Transfer Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Best Available Evidence Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Chief Financial Officer	Chief Financial Officer	Mr.	Grabski	Ben		1-763-300-7611					bgrabski@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	CMS Casework Communication Contact	Sr. Director Compliance	Mr.	Whitbeck	Britton		1-314-209-3989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/08/2022	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Coordination of Benefits Contact			Inquiries	COB		1-855-425-0457					COBInquiry@lumeris.com	P O BOX 5907		TROY	MI	48007	12/06/2022	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoffer	Linda		1-636-686-9682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		1-314-209-2717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Hospice Contact	Director, Pharmacy		Cruz	Jennifer		1-314-770-3556					pharmacy@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Medicare Compliance Officer	VP Internal Audit and Chief Compliance Officer	Ms.	Venable	Erin		1-314-209-3957					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Part D Exceptions Contact		Ms.	Byers	June							June.Byers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				HMO - Health Maintenance Organization		C	Kansas City
H3189	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3189	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				HMO - Health Maintenance Organization		C	Kansas City
H3189	Plan to Plan Reconciliation Contact	Manager, Client Payments		Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3192	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/07/2018	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	12/07/2020	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3192	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3192	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3192	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3204	Automated TrOOP Balance Transfer Contact	Executive Director Pharmacy Services	Mr	Roland	Frank		1-505-923-5530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/24/2021	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Best Available Evidence Contact	Vice President, Chief Financial Officer	Ms	Brannin	Amor		1-505-923-5201				1-505-923-8244	abrannin@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/11/2018	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Chief Financial Officer	Vice President, Chief Financial Officer	Ms	Brannin	Amor		1-505-923-5201				1-505-923-8244	abrannin@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/11/2018	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	CMS Casework Communication Contact	Vice President, Medicare Programs	Ms	Banik	Melissa		1-505-923-8955				1-505-923-5866	mbanik@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Coordination of Benefits Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank		1-505-923-5530					askrx@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/19/2022	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Customer Service Operations Contact	Vice President, PCSC	Ms	Garcia	Kelly		1-505-923-8580				1-505-923-5124	kgarcia3@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/29/2022	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Government Relations Contact	Vice President, Medicare Programs	Ms	Banik	Melissa		1-505-923-8955				1-505-923-5866	mbanik@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Hospice Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank		1-505-923-5530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/28/2021	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Medicare Compliance Officer	Compliance Officer	Ms	Quintana Clyde	Alejandra		1-505-923-7496				1-505-923-8159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Part D Exceptions Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank							froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/28/2021	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	1-505-923-5530				HMO - Health Maintenance Organization		C	Dallas
H3204	Pharmacy Network Management Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank		1-505-923-5530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/28/2021	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Pharmacy Technical Help Desk Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank							froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/28/2021	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	1-866-528-5829				HMO - Health Maintenance Organization		C	Dallas
H3204	Plan to Plan Reconciliation Contact	Data Reporting Specialist, Risk Adjustment	Ms	Pham	Sindy		1-505-923-6012				1-505-923-8244	rpham@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/13/2019	2023	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3206	Automated TrOOP Balance Transfer Contact	Executive Director Pharmacy Services	Mr	Roland	Frank		1-505-923-5530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Best Available Evidence Contact	Vice President, Chief Financial Officer	Ms	Brannin	Amor		1-505-923-5201				1-505-923-8244	abrannin@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/11/2018	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Chief Financial Officer	Vice President, Chief Financial Officer	Ms	Brannin	Amor		1-505-923-5201				1-505-923-8244	abrannin@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/11/2018	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	CMS Casework Communication Contact	Vice President, Medicare Programs	Ms	Banik	Melissa		1-505-923-8955				1-505-923-5866	mbanik@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Coordination of Benefits Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank		1-505-923-5530					askrx@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/19/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Customer Service Operations Contact	Vice President, PCSC	Ms	Garcia	Kelly		1-505-923-8580				1-505-923-5124	kgarcia3@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/29/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Government Relations Contact	Vice President, Medicare Programs	Ms	Banik	Melissa		1-505-923-8955				1-505-923-5866	mbanik@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Hospice Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank		1-505-923-5530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Medicare Compliance Officer	Compliance Officer	Ms	Quintana Clyde	Alejandra		1-505-923-7496				1-505-923-8159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Part D Exceptions Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank							froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active	1-505-923-5530				PPO - BBA		C	Dallas
H3206	Pharmacy Network Management Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank		1-505-923-5530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3206	Pharmacy Technical Help Desk Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank							froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/14/2022	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active	1-866-528-5829				PPO - BBA		C	Dallas
H3206	Plan to Plan Reconciliation Contact	Data Reporting Specialist, Risk Adjustment	Ms	Pham	Sindy		1-505-923-6012				1-505-923-8244	rpham@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/13/2019	2023	PRESBYTERIAN INSURANCE COMPANY, INC.	Local CCP	Presbyterian Insurance Company, Inc.	Local PPO		Presbyterian Healthcare Services	188	Yes	Active					PPO - BBA		C	Dallas
H3219	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	06/21/2022	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-888-736-9118				1-888-554-7668	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/03/2018	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Chief Financial Officer	Chief Financial Officer	Mr.	Jacobsen	Jeffrey		1-651-350-7639					JacobsenJ1@AllinaHealthAetna.com	1550 Utica Ave. S	Suite 250	St. Louis Park	MN	55416	12/18/2018	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active	1-602-618-3945				PPO - BBA		C	Philadelphia
H3219	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3219	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active	1-800-238-6279				PPO - BBA		C	Philadelphia
H3219	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/21/2022	2023	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active					PPO - BBA		C	Philadelphia
H3239	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/06/2019	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3239	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3239	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3239	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3240	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H3240	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H3240	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	AMERIGROUP NEW JERSEY, INC.	Local CCP	Amerigroup Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3251	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Coordination of Benefits Contact	Manager, PBM Operations	Mrs.	Hanson	Michelle		1-612-777-6755				1-000-000-0000	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/29/2020	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Denver
H3251	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3251	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				HMO - Health Maintenance Organization		C	Denver
H3251	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3256	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/02/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H3256	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3256	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H3256	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/21/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3259	Automated TrOOP Balance Transfer Contact	Advisor Business CVS		Davis	Brittany		1-480-606-4613					FIRSupport@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/21/2021	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Best Available Evidence Contact	Director Service Operations		Scissom	Melissa		1-423-535-8356					Melissa_Scissom@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Chief Financial Officer	CFO	Mr	Dungan	Casey		1-423-535-5635					Casey_Dungan@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/04/2019	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	CMS Casework Communication Contact	Clinical Management		Pugh	Donna		1-423-535-6563					Donna_Pugh@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2022	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Coordination of Benefits Contact	Manger Revenue Reconciliation		Camp	Jan		1-423-535-3639					jan_camp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/20/2022	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Customer Service Operations Contact	Director Service Operations		Scissom	Melissa		1-423-535-8356				1-423-591-9109	Melissa_Scissom@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Government Relations Contact	Medicare Compliance Officer		Womble	Charriet		1-615-347-9580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Hospice Contact	Director Service Operations		Scissom	Melissa		1-423-535-8356				1-423-591-9109	Melissa_Scissom@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Womble	Charriet		1-615-347-9580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Part D Exceptions Contact	Manager Coverage Reviews 1		Moss	Portia							Portia_Moss@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/08/2019	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	1-800-831-2583				HMO - Health Maintenance Organization		C	Atlanta
H3259	Pharmacy Network Management Contact	Advisor Network Products CVS		Lowe	David		1-480-744-9231				1-877-387-5800	David.Lowe2@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/20/2021	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3259	Pharmacy Technical Help Desk Contact	Vendor Management		Horton	Kasena							Kasena.Horton@CVSHealth.com	2401 Cherahala  Blvd		Knoxville	TN	37932	12/21/2021	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Atlanta
H3259	Plan to Plan Reconciliation Contact	Business Analyst Associate		Stinnett	James		1-423-535-1624					P2PAdministration_GM@bcbst.com	Attn: P2P Coordinator	1 Cameron Hill Circle Suite 0050	Chattanooga	TN	37402-0050	02/07/2018	2023	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3274	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	02/10/2021	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	06/21/2021	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	06/21/2021	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/23/2021	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/23/2021	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		1-615-481-1897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	08/10/2022	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/23/2021	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Philadelphia
H3274	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/23/2021	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3274	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	02/10/2021	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Philadelphia
H3274	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3276	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		1-860-674-5780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	06/25/2021	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Best Available Evidence Contact	Manager, Vendor Operations		Ewen	Jillian		1-860-674-5780					jewen@connecticare.com	175 Scott Swamp Road	P.O. Box 4050	Farmington	CT	06034-4050	03/23/2020	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		1-646-447-6174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	07/02/2020	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	CMS Casework Communication Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	1-646-447-7215				1-212-510-8130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	07/22/2022	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Coordination of Benefits Contact	Director, Medicare Regulatory Ops		Caracappa	Lisa		1-646-447-7749					lcaracappa@emblemhealth.com	55 Water Street		New York	NY	10041	07/29/2022	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Customer Service Operations Contact	VP, Ops Strategy & Service Delivery		Pandey	Priyank		1-646-447-7543					ppandey@emblemhealth.com	55 Water Street		New York	NY	10041	02/11/2021	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Government Relations Contact	Director, Medicare Compliance		Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	07/29/2019	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Hospice Contact	Senior Medicare Pharmacy Specialist		Der Weer	J'Nisha		1-646-447-7198					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	08/08/2018	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/08/2019	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part D Exceptions Contact	Director		Colby	Andrew							acolby@emblemhealth.com	55 Water street		New York	NY	10041	05/12/2022	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	1-646-447-3340				HMO - Health Maintenance Organization		C	New York
H3276	Pharmacy Network Management Contact	Pharmacy Client Ops Director		Brown	Gregory		1-401-525-1683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2022	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	6625 West 78th street		Bloomington	MN	55439	01/24/2022	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	1-800-922-1557	2			HMO - Health Maintenance Organization		C	New York
H3276	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		1-646-447-3017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	08/16/2022	2023	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3284	Automated TrOOP Balance Transfer Contact	Finance Director		Paulucci	Jia		1-425-985-7716				1-253-472-6833	Jia.Paulucci@multicare.org	6442 S Yakima Avenue		Tacoma	WA	98408	06/16/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Best Available Evidence Contact	CFO		Schramm	Steve		1-253-403-7614				1-253-472-6833	steve.schramm@multicare.org	6442 S Yakima Avenue		Tacoma	WA	98408	07/28/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Chief Financial Officer	CFO	Mr	Schramm	Steve		1-253-403-7614				1-253-472-6833	steve.schramm@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	07/28/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	CMS Casework Communication Contact	Compliance Officer		Clay	Chelsea		1-605-464-4821				1-253-472-6833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Coordination of Benefits Contact	CFO		Schramm	Steve		1-253-403-7614				1-253-472-6833	Jia.Paulucci@multicare.org	6442 S Yakima Avenue		Tacoma	WA	98408	07/28/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Customer Service Operations Contact	Executive Director		Stengel	Laura		1-415-361-6395				1-253-472-6833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	01/14/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Government Relations Contact	Executive Director		Stengel	Laura		1-415-361-6395				1-253-472-6833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	01/14/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Medicare Compliance Officer	Compliance Officer	Mrs	Clay	Chelsea		1-253-312-2773				1-253-472-6833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Part D Exceptions Contact	Compliance Officer		Clay	Chelsea							Chelsea.Clay@multicare.org	6442 S Yakima St		Tacoma	WA	98408	03/18/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active	1-866-264-6121				PACE - Nat		C	Seattle
H3284	Pharmacy Network Management Contact	Compliance Officer		Clay	Chelsea		1-605-464-4821				1-253-473-3117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Pharmacy Technical Help Desk Contact	Compliance Officer		Clay	Chelsea							Chelsea.Clay@multicare.org	6442 S Yakima St		Tacoma	WA	98408	03/18/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active	1-866-264-6121				PACE - Nat		C	Seattle
H3284	Plan to Plan Reconciliation Contact	Finance Director	Mrs	Paulucci	Jia		1-425-985-7716				1-253-472-6833	Jia.Paulucci@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	07/28/2022	2023	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3288	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/10/2018	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-602-618-3945				PPO - BBA		C	Philadelphia
H3288	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3288	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-800-238-6279				PPO - BBA		C	Philadelphia
H3288	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H3291	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/01/2019	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Chief Financial Officer	CFO	Mr	Small	Phil		1-770-279-6200					PhSmall@pruitthealth.com	1626 Jeurgens Ct		Norcross	GA	30093	05/05/2021	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/01/2019	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Christopher	Laura	K	1-404-694-4897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	06/09/2022	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/15/2021	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Atlanta
H3291	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/15/2021	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3291	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Atlanta
H3291	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3305	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					wcolin@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Best Available Evidence Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		1-585-885-2361				1-585-327-2227	RMoxley@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	08/23/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Chief Financial Officer	Chief Financial Officer	Ms.	Austen	Karla		1-518-388-2357					kausten@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/26/2014	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	CMS Casework Communication Contact	Leader, Medicare Appeals		Allen	Amy		1-585-258-8096				1-585-327-5724	aallen@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	09/07/2021	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Coordination of Benefits Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					wcolin@mvphealthcare.com	220 Alexander St.		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Customer Service Operations Contact	Sr. Leader, Customer Care & Support Services		Greenberg	Melissa		1-518-991-3731					mgreenberg@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Government Relations Contact	Medicare Compliance Officer		Borges	Linda		1-518-991-3803				1-518-836-3202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Hospice Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					WColin@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Borges	Linda		1-518-991-3803				1-518-836-3202	MCO@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Part D Exceptions Contact	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	220 Alexander St.		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active	1-585-885-2435				HMO - Health Maintenance Organization		C	New York
H3305	Pharmacy Network Management Contact	Director Network Operations		Smith	Shawn		1-480-391-4844					shawn.smith@cvshealth.com	9501 E. Shea Blvd. MC 080		Scottsdale	AZ	85260	07/18/2018	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3305	Pharmacy Technical Help Desk Contact	Director, Client Operations		Leeper	Shonda							Shonda.Leeper@CVSHealth.com	445 Great Circle Rd		Nashville	TN	37228	12/03/2021	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H3305	Plan to Plan Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		1-914-429-8496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3307	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/02/2021	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H3307	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3307	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/17/2020	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H3307	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	OXFORD HEALTH PLANS (NY), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3312	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3312	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3312	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3312	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3321	Automated TrOOP Balance Transfer Contact	Director of Quality Management		Barrington	Michele		1-315-413-4595				1-315-703-3599	mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	Best Available Evidence Contact	Director of Quality Management		Barrington	Michele		1-315-413-4595				1-315-703-3599	mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	Chief Financial Officer	Corporate Controller	Mr.	Murray	John	G	1-315-413-3206					jmurray@lorettosystem.org	700 E. Brighton Ave		Syracuse	NY	13205	09/26/2017	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	CMS Casework Communication Contact	Executive Director		Button	Stephanie		1-315-452-5800				1-315-459-7113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/16/2017	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	Coordination of Benefits Contact	Compliance Officer/Med Rec Dir		Nutting	Barbara		1-315-413-3126				1-315-469-4737	bnutting@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	04/07/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	Customer Service Operations Contact	Marketing Director	Mrs.	Natoli	Tammy		1-315-413-4579				1-315-459-7113	tnatoli@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	05/03/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	Government Relations Contact	Executive Director	Mrs.	Button	Stephanie		1-315-413-3437				1-315-703-3599	sbutton@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	Medicare Compliance Officer	Compliance Officer/ Med Rec Dir	Ms	Nutting	Barbara		1-315-413-3126				1-315-469-4737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	Part D Exceptions Contact	Director of Quality Management		Barrington	Michele							mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active	1-888-728-7223				PACE - Nat		C	New York
H3321	Pharmacy Network Management Contact	Director of Quality Management	Ms.	Barrington	Michele		1-315-413-4595					mbarrington@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	08/29/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3321	Pharmacy Technical Help Desk Contact	Medical Director		Heisig	David							dheisig@lorettosystem.org	109 Lawrence Road		North Syracuse	NY	13212	02/24/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active	1-888-728-7223				PACE - Nat		C	New York
H3321	Plan to Plan Reconciliation Contact	Director of Quality Management	Ms.	Barrington	Michele		1-315-413-4595				1-315-703-3599	mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2023	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active					PACE - Nat		C	New York
H3322	Automated TrOOP Balance Transfer Contact	Finance Supervisor	Ms.	Wittman	Michele		1-518-270-1734				1-518-274-1829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Best Available Evidence Contact	Finance Supervisor	Ms.	Wittman	Michele		1-518-270-1734				1-518-274-1829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Chief Financial Officer	Finance Director	Mrs.	Turo	Lynette		1-518-270-1346				1-518-274-2908	Lynette.Turo@sphp.com	Eddy SeniorCare	433 River Street, 3rd Floor	Troy	NY	12180	12/01/2021	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	CMS Casework Communication Contact	Executive Director	Ms.	Mazzacco	Michelle		1-518-669-2694				1-518-382-3398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Coordination of Benefits Contact	Finance Supervisor	Ms.	Wittman	Michele		1-518-270-1734				1-518-274-8129	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Customer Service Operations Contact	Executive Director	Ms.	Mazzacco	Michelle		1-518-669-2694				1-518-382-3398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Government Relations Contact	Executive Director	Ms.	Mazzacco	Michelle		1-518-669-2694				1-518-382-3398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Medicare Compliance Officer	Compliance Liaison	Mrs.	Mazzacco	Michelle		1-518-382-3290					Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	03/24/2022	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part D Exceptions Contact	Finance Supervisor	Ms.	Wittman	Michele						1-518-274-1829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	1-855-376-7888				PACE - Nat		C	New York
H3322	Pharmacy Network Management Contact	Executive Director		Mazzacco	Michelle		1-518-669-2694				1-518-382-3398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Pharmacy Technical Help Desk Contact	Executive Director		Mazzacco	Michelle						1-518-382-3398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	1-855-376-7888				PACE - Nat		C	New York
H3322	Plan to Plan Reconciliation Contact	Finance Supervisor	Ms.	Wittman	Michele		1-518-270-1734				1-518-274-1829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2023	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3329	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Rivera-Aquino	Denisse		1-858-291-5269					partdcat@medimpact.com	136-65 37th Ave.		Flushing	NY	11354	01/03/2023	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Best Available Evidence Contact	CFO	Ms.	Tirtasaputra	Leny		1-347-501-2901					ltirtasaputra@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Chief Financial Officer	CFO	Ms..	Tirtasaputra	Leny		1-347-501-2901					ltirtasaputra@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	CMS Casework Communication Contact	VP of Quality	Ms.	St Fleur	Gilda		1-347-387-7782					gstfleur@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Coordination of Benefits Contact	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		1-646-483-1796					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Customer Service Operations Contact	VP of Operations	Ms.	Tabakovic	Emina		1-347-920-6110				1-617-223-6932	etabakovic@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Government Relations Contact	Director Of Compliance	Mr.	Fairweather	Adrian		1-929-505-1346					afairweather@centerlight.org	136-65 37th Avenue		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Medicare Compliance Officer	Chief Compliance Officer	Ms	Nelson Jones	Alicia		1-347-443-0157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part D Exceptions Contact	Director of PA & UM Programs	Ms.	Emoto	Julianne							julianne.emoto@medimpact.com	136-65 37th Ave.		Flushing	NY	11354	01/03/2023	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active	1-858-790-5846				PACE - Nat		C	New York
H3329	Pharmacy Network Management Contact	Pharmacy Director	Ms.	Jing	Shu		1-917-697-7979					sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Pharmacy Technical Help Desk Contact	VP, Contact Center Services		Battle	Dorry							customerservice@medimpact.com	136-65 37th Ave.		Flushing	NY	11354	12/30/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active	1-858-291-5348				PACE - Nat		C	New York
H3329	Plan to Plan Reconciliation Contact	Sr. Accountant		Barsamyan	Anahit		1-201-655-5825					abarsamyan@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2023	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Teamcare	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3330	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		1-860-674-5780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	06/25/2021	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Best Available Evidence Contact	Manager, Vendor Operations		Ewen	Jillian		1-860-674-5780					jewen@connecticare.com	175 Scott Swamp Road	P.O. Box 4050	Farmington	CT	06034-4050	03/23/2020	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		1-646-447-6174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	07/02/2020	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	CMS Casework Communication Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	1-646-447-7215				1-212-510-8130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	07/22/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Coordination of Benefits Contact	Sr. Dir., Claims Operations & Provider Data Mgmt		Gauthier	Kathleen	H	1-860-409-6435					kgauthier@connecticare.com	55 Water Street		New York	NY	10041	07/15/2021	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Customer Service Operations Contact	VP, Ops Strategy & Service Delivery		Pandey	Priyank		1-646-447-7543					ppandey@emblemhealth.com	55 Water Street		New York	NY	10041	02/17/2021	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Government Relations Contact	Director, Medicare Compliance		Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/09/2019	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Hospice Contact	Senior Medicare Pharmacy Specialist		Der Weer	J'Nisha		1-646-447-7198					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	07/30/2019	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/08/2019	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Exceptions Contact	Director		Colby	Andrew							acolby@emblemhealth.com	55 Water street		New York	NY	10041	05/12/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	1-646-447-3340				HMO - Health Maintenance Organization		C	New York
H3330	Pharmacy Network Management Contact	Pharmacy Client Ops Director		Brown	Gregory		1-401-525-1683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	6625 West 78th street		Bloomington	MN	55439	01/24/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	1-800-922-1557	2			HMO - Health Maintenance Organization		C	New York
H3330	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		1-646-447-3017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	08/16/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3331	Automated TrOOP Balance Transfer Contact	Director, Business Development	Mrs.	Ralston	Kathy		1-585-922-2812				1-585-922-2864	katherine.ralston@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	01/27/2021	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	Best Available Evidence Contact	Director, Business Development	Mrs.	Ralston	Kathy		1-585-922-2812				1-585-922-2864	katherine.ralston@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	01/27/2021	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	Chief Financial Officer	CFO, Extended Acute Care Services	Mr.	Caprino	Albert		1-585-922-1796					Albert.Caprino@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	12/22/2022	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	CMS Casework Communication Contact	Regulatory Compliance Specialist	Ms.	Miller	Amanda		1-585-922-9956				1-585-922-2864	Amanda.miller4@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	02/23/2022	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	Coordination of Benefits Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		1-585-922-2867				1-585-922-2864	JeanMarie.Mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	12/22/2022	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	Customer Service Operations Contact	CFO, Extended Acute Care Services	Mr.	Caprino	Albert		1-585-922-1796					Albert.Caprino@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	12/22/2022	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	Government Relations Contact	Regulatory Compliance Specialist	Ms.	Miller	Amanda		1-585-922-9956				1-585-922-2864	Amanda.miller4@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	02/23/2022	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	Medicare Compliance Officer	VP Internal Audit & Corporate Compliance	Mrs.	Gallagher	K Ellen		1-585-353-8099					Jamie.Leibowitz@RochesterRegional.org	100 Kings Highway South		Rochester	NY	14617	10/05/2021	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	Part D Exceptions Contact	Medical Director		Ryan	Stephen						1-585-922-2855	stephen.ryan@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	01/27/2021	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active	1-855-457-4636				PACE - Nat		C	New York
H3331	Pharmacy Network Management Contact	Vice President		Neidel	Kristi		1-585-922-9950				1-585-922-2864	Kristi.Neidel@RochesterRegional.org	490 E. Ridge Road		Rochester	NY	14621	04/19/2021	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3331	Pharmacy Technical Help Desk Contact	CFO, Extended Care Services		Caprino	Albert							Albert.Caprino@rochesterregional.org	100 Kings Highway South		Rochester	NY	14617	12/22/2022	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active	1-585-922-1796				PACE - Nat		C	New York
H3331	Plan to Plan Reconciliation Contact	CFO, Extended Acute Care Services	Mr.	Caprino	Albert		1-585-922-1796					Albert.Caprino@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	12/22/2022	2023	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active					PACE - Nat		C	New York
H3335	Automated TrOOP Balance Transfer Contact	Medicare Product Operations Specialist		Laird	Jennifer		1-585-339-7717					Jennifer.Laird@excellus.com	165 Court Street		Rochester	NY	14647	04/26/2014	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Best Available Evidence Contact	Supervisor Medicare Operations		Piershalski	Dana		1-716-857-4435				1-716-857-6160	medicare.reconciliation.unit@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Chief Financial Officer	Executive Vice President & Chief Financial Officer	Mr.	Gorecki	Christophe	M	1-480-993-5254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	CMS Casework Communication Contact	Medicare Compliance Program Administrator		Gomez	Rafael		1-716-857-6226					Rafael.Gomez@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Coordination of Benefits Contact	Supervisor, Other Party Liability		May	Mary		1-315-792-8873					Mary.May@excellus.com	12 Rhoads Dr.		Utica	NY	13502	04/15/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Customer Service Operations Contact	Vice President, Customer Care		Levi	Alexander		1-585-399-6683					Alexander.Levi@excellus.com	300 Main St.		East Rochester	NY	14445	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Government Relations Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		1-585-339-7745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Hospice Contact	Manager, Pharmacy Utilization Management		Khan	Joe		1-716-843-7881					Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	09/29/2020	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dibble	Laura		1-585-339-7745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Part D Exceptions Contact	Manager, Pharmacy Utiization Management		Khan	Joe							Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	09/29/2020	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	1-716-843-7881				PPO - BBA		C	New York
H3335	Pharmacy Network Management Contact	Pharmacy Operations Support		Brown	Burt		1-585-327-7530				1-585-339-6640	Burt.Brown@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3335	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkway	Ste 150	Temple Terrace	FL	33637	11/19/2021	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	1-800-922-1557				PPO - BBA		C	New York
H3335	Plan to Plan Reconciliation Contact	Manager, Finance Operations		Simmons	Jennifer		1-585-231-6874					Jennifer.Simmons@excellus.com	165 Court Street		Rochester	NY	14647	12/08/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	New York
H3342	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H3342	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3342	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H3342	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Local CCP	Empire BlueCross BlueShield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H3344	Automated TrOOP Balance Transfer Contact	Directory-Pharmacy Services and Operations		Malcolm	Jillian		1-716-635-3754					Jillian.Malcolm@Independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Best Available Evidence Contact	Manager - Enrollment Operations		Sell	Melanie		1-716-250-7321				1-716-250-7162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Chief Financial Officer	Executive Vice President - Chief Financial Officer	Mr.	Dunlop	James		1-716-631-3001					James.Dunlop@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/06/2021	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	CMS Casework Communication Contact	Manager Enrollment Operations		Sell	Melanie		1-716-250-7321				1-716-250-7162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Coordination of Benefits Contact	Manager - Corporate Recoveries		Abou-Said	Kelly		1-716-635-3758					Kelly.Abou-Said@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/07/2022	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Customer Service Operations Contact	Manager - Servicing		Plotner	Jenna		1-716-250-4424					Jenna.Plotner@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/22/2021	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Government Relations Contact	SVP Government Programs		Tracy	Robert		1-716-635-4904					Robert.Tracy@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Hospice Contact	Director-Pharmacy Services and Operations		Malcolm	Jillian		1-716-635-3754					Jillian.Malcolm@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Britton	Nicole		1-716-635-4874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/20/2018	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Part D Exceptions Contact	VP- Pharmacy Services		Burruano	Martin						1-716-631-0149	Martin.Burruano@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active	1-800-247-1466	5311			PPO - BBA		C	New York
H3344	Pharmacy Network Management Contact	VP Pharmacy Services		Burruano	Martin		1-716-225-7559				1-716-631-9636	Martin.Burruano@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3344	Pharmacy Technical Help Desk Contact	Supervisor-Member Servicing		Bates	Taylor							Taylor.Bates@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/02/2022	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active	1-800-993-9898				PPO - BBA		C	New York
H3344	Plan to Plan Reconciliation Contact	Pharmacy Systems Gov. Programs Manager		Miszuk	Jane		1-716-635-7857					Jane.Miszuk@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/11/2019	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	New York
H3347	Automated TrOOP Balance Transfer Contact	Pharmacy Specialist II		Yang	Micheal		1-718-759-4064					MYANG@mjhs.org	6323 Seventh Avenue		Brooklyn	NY	11220	12/22/2021	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Best Available Evidence Contact	Director of Member Operations		Lewis	Alison		1-718-630-2608				1-718-630-1709	alewis@mjhs.org	6323 Seventh Avenue		Brooklyn	NY	11220	01/18/2019	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Chief Financial Officer	Chief Financial Officer	Mr.	Koschitzki	David		1-718-491-7208					dkoschit@mjhs.org	6323 Seventh Avenue		Brooklyn	NY	11220	02/22/2019	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	CMS Casework Communication Contact	AVP, Regulatory Compliance		Weatherly	Candice		1-718-759-4260					cweather@mjhs.org	6323 Seventh Avenue	3rd Floor	Brooklyn	NY	11220	02/22/2019	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Coordination of Benefits Contact	Director of Member Operations		Lewis	Alison		1-718-630-2608				1-718-630-1709	alewis@mjhs.org	6323 Seventh Avenue		Brooklyn	NY	11220	01/18/2019	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Customer Service Operations Contact	Director of Service Operations	Ms	Alston	Doretha		1-718-921-7830					DALSTON@MJHS.ORG	6323 Seventh Avenue		Brooklyn	NY	11220	11/19/2018	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Government Relations Contact	AVP, Regulatory Compliance		Weatherly	Candice		1-718-759-4260					cweather@mjhs.org	6323 Seventh Avenue	3rd Floor	Brooklyn	NY	11220	02/22/2019	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Hospice Contact	VP, Pharmacy		Ference	Eunice		1-718-630-2691					eference@mjhs.org	6323 Seventh Avenue		Brooklyn	NY	11220	02/12/2018	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Medicare Compliance Officer	AVP, Regulatory Compliance	Ms.	Weatherly	Candice		1-718-759-4260					cweather@mjhs.org	6323 Seventh Avenue	3rd Floor	Brooklyn	NY	11220	02/22/2019	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part D Exceptions Contact	VP, Pharmacy		Ference	Eunice							eference@mjhs.org	Elderplan, Inc.	6323 Seventh Avenue	Brooklyn	NY	11220	02/12/2018	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active	1-718-630-2691				HMO - Health Maintenance Organization		C	New York
H3347	Pharmacy Network Management Contact	VP, Pharmacy		Ference	Eunice		1-718-630-2691					eference@mjhs.org	Elderplan, Inc.	745 64th Street	Brooklyn	NY	11220	02/12/2018	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Pharmacy Technical Help Desk Contact	Advisor		Rodriguez	Alex							Alex.rodriguez@cvshealth.com	CVS Health	9501 E Shea Blvd	Scottsdale	AZ	85260	12/16/2020	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H3347	Plan to Plan Reconciliation Contact	VP, Medicaid & Integrated Products		Johnson	John-Chad		1-718-921-7922					jcjohnso@mjhs.org	6323 Seventh Avenue		Brooklyn	NY	11220	10/20/2022	2023	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Automated TrOOP Balance Transfer Contact	Medicare Product Operations Specialist		Laird	Jennifer		1-585-339-7717					Jennifer.Laird@excellus.com	165 Court Street		Rochester	NY	14647	04/28/2014	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Best Available Evidence Contact	Supervisor Medicare Operations		Piershalski	Dana		1-716-857-4435				1-716-857-6160	medicare.reconciliation.unit@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Chief Financial Officer	Executive Vice President & Chief Financial Officer	Mr.	Gorecki	Christophe	M	1-480-993-5254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	CMS Casework Communication Contact	Medicare Compliance Program Administrator		Gomez	Rafael		1-716-857-6226					Rafael.Gomez@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Coordination of Benefits Contact	Supervisor, Other Party Liability		May	Mary		1-315-792-8873					Mary.May@excellus.com	12 Rhoads Dr.		Utica	NY	13502	04/15/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Customer Service Operations Contact	Vice President, Customer Care		Levi	Alexander		1-585-399-6683					Alexander.Levi@excellus.com	300 Main St.		East Rochester	NY	14445	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Government Relations Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		1-585-339-7745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Hospice Contact	Manager, Pharmacy Utilization Management		Khan	Joe		1-716-843-7881					Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dibble	Laura		1-585-339-7745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Part D Exceptions Contact	Manager, Pharmacy Utiization Management		Khan	Joe							Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	09/29/2020	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	1-716-843-7881				HMO - Health Maintenance Organization		C	New York
H3351	Pharmacy Network Management Contact	Pharmacy Operations Support		Brown	Burt		1-585-327-7530				1-585-339-6640	Burt.Brown@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkway	Ste 150	Temple Terrace	FL	33637	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H3351	Plan to Plan Reconciliation Contact	Manager, Finance Operations		Simmons	Jennifer		1-585-231-6874					Jennifer.Simmons@excellus.com	165 Court Street		Rochester	NY	14647	12/08/2022	2023	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Automated TrOOP Balance Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	12/23/2019	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Best Available Evidence Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	12/23/2019	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Chief Financial Officer	Chief Financial Officer	Mr.	Bermel	John		1-212-479-2777					jbermel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/05/2016	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	CMS Casework Communication Contact	Complaints Manager	Ms.	Gabriel	Charisse		1-646-767-5697					cgabriel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/18/2021	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Coordination of Benefits Contact	Director, Payment Integrity Team	Ms.	Hutchinson	Chris		1-917-698-2415					chutchinson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/08/2021	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Customer Service Operations Contact	VP,  Member Services	Ms.	O'Connor	Kimberly		1-212-801-1639					koconnor@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	06/02/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Government Relations Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		1-646-313-8967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	12/01/2014	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Hospice Contact	Director, Pharmacy Operations	Ms.	Lee Brown	Hannah		1-646-429-3818					hleebrown@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	06/02/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Medicare Compliance Officer	Chief Compliance Officer & Head of Internal Audit	Mr.	Hackendorn	John		1-212-453-4495					jhackendorn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	01/16/2020	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Part D Exceptions Contact	Director, Pharmacy Operations	Ms.	Lee Brown	Hannah							hleebrown@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	06/02/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	1-888-260-1010				HMO - Health Maintenance Organization		C	New York
H3359	Pharmacy Network Management Contact	Director, Pharmacy Operations	Mr.	Suri	Tarun		1-646-354-1168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	06/15/2021	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3359	Pharmacy Technical Help Desk Contact	Director, Client Operations	Ms.	Dayoub	Joselyn							dayoubj@cvshealth.com	CVS Health	800 NW Chipman Rd, Ste 5830	Lees Summit	MO	64063	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H3359	Plan to Plan Reconciliation Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor	Attn:  Treasury Department	New York	NY	10007	04/25/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Automated TrOOP Balance Transfer Contact	Manager-Pharmacy Operations		Malcolm	Jillian		1-716-635-3754					Jillian.Malcolm@Independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Best Available Evidence Contact	Manager - Enrollment Operations		Sell	Melanie		1-716-250-7321				1-716-250-7162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Chief Financial Officer	Executive Vice President - Chief Financial Officer	Mr.	Dunlop	James		1-716-631-3001					James.Dunlop@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/06/2021	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	CMS Casework Communication Contact	Manager Enrollment Operations		Sell	Melanie		1-716-250-7321				1-716-250-7162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Coordination of Benefits Contact	Manager - Corporate Recoveries		Abou-Said	Kelly		1-716-635-3758					Kelly.Abou-Said@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/07/2022	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Customer Service Operations Contact	Manager - Servicing		Plotner	Jenna		1-716-250-4424					Jenna.Plotner@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/22/2021	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Government Relations Contact	SVP Government Programs		Tracy	Robert		1-716-635-4904					Robert.Tracy@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Hospice Contact	Manager- Pharmacy Operations		Malcolm	Jillian		1-716-635-3754					Jillian.Malcolm@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/19/2018	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Britton	Nicole		1-716-635-4874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/20/2018	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Part D Exceptions Contact	VP- Pharmacy Services		Burruano	Martin						1-716-631-0149	Martin.Burruano@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active	1-800-247-1466	5311			HMO - Health Maintenance Organization		C	New York
H3362	Pharmacy Network Management Contact	VP Pharmacy Services		Burruano	Martin		1-716-225-7559				1-716-631-9636	Martin.Burruano@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3362	Pharmacy Technical Help Desk Contact	Supervisor-Member Servicing		Bates	Taylor							Taylor.Bates@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/02/2022	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active	1-800-993-9898				HMO - Health Maintenance Organization		C	New York
H3362	Plan to Plan Reconciliation Contact	Pharmacy Systems Gov. Programs Manager		Miszuk	Jane		1-716-635-7857					Jane.Miszuk@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/11/2019	2023	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3379	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/02/2021	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H3379	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3379	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H3379	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3384	Automated TrOOP Balance Transfer Contact	Manager, Federal Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-3075	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Best Available Evidence Contact	Manager		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Chief Financial Officer	CFO Highmark Health Plan	Mr.	Veach	Daryl		1-412-544-7531					Daryl.Veach@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/14/2021	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	CMS Casework Communication Contact	Manager, Government Programs Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		1-412-544-4417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	06/03/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Customer Service Operations Contact	Manager, Member Customer Service		Sheridan	Rebecca	L	1-518-220-5661				1-518-423-2294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Government Relations Contact	SVP, Government Affiars	Mr.	Warfel	Michael	G	1-717-302-3979					michael.warfel@highmark.com	1800 Center St.		Camp Hill	PA	17011	03/18/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Hospice Contact	Intake Coordinator		Welker	Jessica		1-717-888-3043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	11/08/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		1-412-544-7031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite P4207	Pittsburgh	PA	15222	11/08/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active	1-800-600-2227				HMO - Health Maintenance Organization		C	Philadelphia
H3384	Pharmacy Network Management Contact	Network Account Director, Retail Strategy&Contract		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/30/2016	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3384	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	12/17/2021	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Philadelphia
H3384	Plan to Plan Reconciliation Contact	Manager, Federal Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	PO Box 80	Attention: Christa Dipasquale	Buffalo	NY	14240-0080	05/05/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3387	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H3387	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3387	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/18/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H3387	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3388	Automated TrOOP Balance Transfer Contact	Pharmacy Compliance Coordinator		Bedell	Luke		1-518-641-4664				1-518-641-4605	luke.bedell@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	04/27/2015	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Best Available Evidence Contact	Manager, Membership & Billing		Salzer	Cheryl		1-518-641-4170					cheryl.salzer@cdphp.com	500 Patroon Creek Blvd.		Albany	NY	12206	04/27/2015	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Chief Financial Officer	Medicare Compliance Officer	Mr	Schoonmaker	Dennis		1-518-641-5275				1-518-641-4006	dennis.schoonmaker@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	12/31/2022	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	CMS Casework Communication Contact	Medicare Compliance Officer		Schoonmaker	Dennis		1-518-641-5275				1-518-641-4605	dennis.schoonmaker@cdphp.com	500 Patroon Creek Corporate Center		Albany	NY	12206	03/16/2020	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Coordination of Benefits Contact	Medicare Reimbursement Coordinator		Moye	Nancy		1-518-641-5274				1-518-641-4605	Medicare_Compliance_Inquiries@cdphp.com	500 Patroon Creek Corporate Center		Albany	NY	12206	04/18/2022	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Customer Service Operations Contact	Director, Member Services		Kordas	Laura		1-518-641-3710				1-518-641-3507	laura.kordas@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	04/27/2015	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Government Relations Contact	VP Communications and External Affairs		Skinner	Ali		1-518-641-5035				1-518-641-5506	ali.skinner@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	11/16/2022	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Hospice Contact	Pharmacy Compliance Coordinator		Bedell	Luke		1-518-641-4664					luke.bedell@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	01/30/2018	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Medicare Compliance Officer	Medicare Compliance Officer	Mr	Schoonmaker	Dennis	M	1-518-641-5275				1-518-641-4605	dennis.schoonmaker@cdphp.com	500 Patroon Creek Corporate Center		Albany	NY	12206	05/18/2020	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Part D Exceptions Contact	Lead Managed Care Pharmacist		Reed	Lisa						1-518-641-3208	lisa.reed@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	05/16/2016	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active	1-518-641-3231				HMO - Health Maintenance Organization		C	New York
H3388	Pharmacy Network Management Contact	Vice President of Pharmacy & Health Quality Pgrms		Wood	Eileen		1-518-641-3215				1-518-641-3508	eileen.wood@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	04/27/2015	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3388	Pharmacy Technical Help Desk Contact	Director, Customer Care		Ellerhorst	Lisa							lellerhorst@cap-rx.com	228 Park Avenue South	Suite 87234	New York	NY	10003	12/28/2022	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active	1-833-599-1018				HMO - Health Maintenance Organization		C	New York
H3388	Plan to Plan Reconciliation Contact	Dir. Risk Adjustment and Recovery		Nasadoski	Tom		1-518-641-4601				1-518-641-4102	P2PADMIN@cdphp.com	Attn Risk Management - P2P	500 Patroon Creek Blvd	Albany	NY	12206	06/20/2019	2023	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3404	Automated TrOOP Balance Transfer Contact	Director, Operations		Allie	Cindy		1-612-777-6772					CAllie@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/21/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		1-919-765-2438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Chief Financial Officer	SVP, Chief Financial Officer and Treasurer	Mr.	Perry	Mitchell	W	1-919-765-3923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/21/2018	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	CMS Casework Communication Contact	Mgr, Op Qual & Compliance - Regulatory Complaints		Henderson	Nicole		1-919-765-1320					Caseworker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/29/2019	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Coordination of Benefits Contact	Team Lead, Claims		McGregory	Ann		1-336-201-4530					Ann.McGregory@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	5660 University Pkwy	Winston Salem	NC	27105	07/15/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		1-919-765-7057					Renita.Woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	07/18/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Government Relations Contact	Director, CMS Contract Administration		Washington-McNeill	Deborah		1-336-692-3556				1-336-659-2969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	5660 University Pkwy	Winston-Salem	NC	27105	06/15/2017	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Hospice Contact	Pharmacy Services Specialist		Leggett	Ursula		1-919-765-4599					Ursula.Leggett@bcbsnc.com	PO Box 2291		Durham	NC	27702	09/14/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Medicare Compliance Officer	VP,Comml & Medicare Compliance, Compliance Officer	Mrs.	Dreyer	Amber		1-984-960-3306					amber.dreyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	02/06/2020	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Exceptions Contact	Manager, Pharmacy		Swanson	Ryan							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/14/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active	1-888-296-9790				PPO - BBA		C	Atlanta
H3404	Pharmacy Network Management Contact	AVP, Pharmacy Government Programs		Geter	Joseph		1-919-765-7733					joseph.geter@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/17/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3404	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							MGarzarodriguez@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/13/2020	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active	1-877-277-7893				PPO - BBA		C	Atlanta
H3404	Plan to Plan Reconciliation Contact	Manager, Financial Accounting & Reporting		Hitchcock	Grace		1-919-765-7999					grace.hitchcock@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	PO Box 30060 Mailstop 700-1AP	Durham	NC	27702	12/29/2021	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					PPO - BBA		C	Atlanta
H3407	Automated TrOOP Balance Transfer Contact			Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/05/2019	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Best Available Evidence Contact			Martinez	Edgar		1-915-298-7198	1064				edmartinez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/24/2019	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Chief Financial Officer	Chief Financial Officer	Mr.	Gonzalez	Gustavo		1-915-298-7198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/23/2020	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	CMS Casework Communication Contact			Gibson	Catherine		1-915-298-7198	1258				cgibson@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/07/2022	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Coordination of Benefits Contact	Chief Finanical Officer		Gonzalez	Gustavo		1-915-298-7198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	09/26/2022	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Customer Service Operations Contact	Sr. Director of Member Operations		Martinez	Edgar		1-915-298-7198	1064				edmartinez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/18/2022	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Government Relations Contact	Chief Compliance Officer	Ms	Gibson	Catherine		1-915-298-7198	1258				cgibson@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/18/2022	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Hospice Contact			Herrada	Dolores		1-915-298-7198	1007				dherrada@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	09/04/2019	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Medicare Compliance Officer	Chief Compliance and Privacy Officer	Ms.	Gibson	Catherine		1-915-298-7198	1258				cgibson@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/18/2022	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Part D Exceptions Contact			Murphy	Eileen						1-608-729-2525	eileen.murphy@navitus.com	361 Integrity Drive		Madison	WI	53713	02/03/2020	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active	1-608-729-1525				HMO - Health Maintenance Organization		C	Denver
H3407	Pharmacy Network Management Contact			Miller	Steven		1-920-221-4272					steven.miller@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/06/2019	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3407	Pharmacy Technical Help Desk Contact			Lemmers	Gay						1-866-595-1975	gay.lemmers@navitus.com	1025 West Navitus		Appleton	WI	54913	04/24/2020	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active	1-866-270-3877				HMO - Health Maintenance Organization		C	Denver
H3407	Plan to Plan Reconciliation Contact			Saucedo	Perla		1-915-298-7198	1035				psaucedo@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/25/2019	2023	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Advantage Dual SNP	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3416	Automated TrOOP Balance Transfer Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	1-952-883-6536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Best Available Evidence Contact	Manager Membership Accounting		Marty	Amanda	E	1-952-967-7685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	55440-1309	11/05/2021	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Chief Financial Officer	Treasurer	Ms.	Cermak	Penny	D	1-952-883-7918					penny.d.cermak@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	55440-1309	09/13/2022	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	CMS Casework Communication Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	1-952-967-7679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	55440-9463	12/02/2022	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Coordination of Benefits Contact	Manager, Claims Production		Prine	Chantelle	M	1-952-967-7335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	55440-1309	04/20/2022	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Customer Service Operations Contact	Director  Manager Member Services		Renneke	Alison		1-952-967-7668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	55440-9463	01/29/2020	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Government Relations Contact	VP Government Programs		Clelland	Jennifer	J	1-952-967-5119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	55440-1309	08/30/2021	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Hospice Contact	Pharmacy Compliance Specialist		Riggs	Ben	H	1-952-851-8421					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Medicare Compliance Officer	VP Internal Audit Comp Officer	Mr.	Bunde	Steven	D	1-952-883-6541				1-952-883-5522	steven.d.bunde@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	12/03/2021	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Part D Exceptions Contact	Supervisor, Clinical Review		Whelan	Hillary	A					1-888-883-5434	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active	1-800-492-7259				PPO - BBA		C	Chicago
H3416	Pharmacy Network Management Contact	Director Pharmacy Sales & Product Support		Friday	Ken	R	1-952-967-5826				1-952-967-6667	kenneth.r.friday@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3416	Pharmacy Technical Help Desk Contact	Manager Health Plan Pharmacy Customer Service		Whelan	Hillary	A					1-888-883-5434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/19/2022	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active	1-800-492-7259				PPO - BBA		C	Chicago
H3416	Plan to Plan Reconciliation Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	1-952-883-6584				1-952-883-6500	kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	55440-1309	01/15/2016	2023	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	Local CCP	HealthPartners UnityPoint Health	Local PPO		HealthPartners UnityPoint Health, Inc.	648	Yes	Active					PPO - BBA		C	Chicago
H3418	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/15/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/05/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H3418	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3418	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H3418	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3419	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/17/2020	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/17/2020	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/17/2020	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Medicare Compliance Officer	Compliance Officer	Mrs.	Olesky	Lisa		1-513-275-7952					lisa.olesky@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	06/07/2022	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/15/2021	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Chicago
H3419	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/15/2021	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/17/2020	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Chicago
H3419	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3430	Automated TrOOP Balance Transfer Contact	VP of PACE and Elder Services		Pettry	Jason		1-727-324-1843					jasonpettry@empathhealth.org	6774 102nd Ave.		Pinellas Park	FL	33782	11/23/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Best Available Evidence Contact	VP of PACE and Elder Services		Pettry	Jason		1-727-324-1843					jasonpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	11/23/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Chief Financial Officer	Chief Financial Officer	Ms.	Bouhamid	Saida		1-727-523-3339				1-727-523-2122	sbouhamid@tidewell.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	06/09/2021	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	CMS Casework Communication Contact	VP of PACE and Elder Services	Mr.	Pettry	Jason		1-727-324-1843					jasonpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	11/23/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Coordination of Benefits Contact	VP of PACE and Elder Services	Mr.	Pettry	Jason		1-727-289-0062	1843				jasonpettry@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	11/23/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Customer Service Operations Contact	VP of PACE and Elder Services	Mr	Pettry	Jason		1-727-289-0062	1843				jasonpettry@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	11/23/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Government Relations Contact	VP- Home Health and Elder Services	Mr.	Pettry	Jason		1-727-324-1843					jasonpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	11/23/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Medicare Compliance Officer	Director of Organizational Integrity	Ms	Mosby	Laura		1-727-523-2106				1-727-523-2122	lauramosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	10/17/2016	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Part D Exceptions Contact	VP of PACE and Elder Services	Mr	Pettry	Jason						1-727-324-1866	jasonpettry@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	11/23/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active	1-727-324-1843				PACE - Nat		C	Atlanta
H3430	Pharmacy Network Management Contact	Manager Client Services	Mr.	Summers	Todd		1-866-443-1095					todd.summers@optum.com	1600 McConnor Parkway		Schaumberg	IL	60173	01/07/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Pharmacy Technical Help Desk Contact	Manager Client Services	Mr.	Summers	Todd							todd.summers@optum.com	1600 McConnor Parkway		Schaumberg	IL	60173	01/07/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active	1-866-443-1095				PACE - Nat		C	Atlanta
H3430	Plan to Plan Reconciliation Contact	VP of PACE and Elder Services		Pettry	Jason		1-727-324-1843					jasonpettry@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	11/23/2022	2023	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3442	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/15/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/05/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H3442	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3442	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H3442	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H3443	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	02/15/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	San Francisco
H3443	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	03/31/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3443	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/21/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				HMO - Health Maintenance Organization		C	San Francisco
H3443	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	02/15/2021	2023	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3447	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/06/2021	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H3447	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H3447	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2023	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3449	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations		Hanson	Michelle		1-612-777-6706					eobp2p@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		1-919-765-2438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Chief Financial Officer	SVP, Chief Financial Officer and Treasurer	Mr.	Perry	Mitchell	W	1-919-765-3923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/21/2018	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	CMS Casework Communication Contact	Mgr, Op Qual & Compliance - Regulatory Complaints		Henderson	Nicole		1-919-765-1320					Caseworker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/26/2019	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Coordination of Benefits Contact	Team Leader, Claims		McGregory	Ann		1-336-201-4530					Ann.McGregory@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	5660 University Pkwy	Winston Salem	NC	27105	07/15/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		1-919-765-7057					Renita.Woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	07/18/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Government Relations Contact	Director, CMS Contract Administration		Washington-McNeill	Deborah		1-336-692-3556				1-336-659-2969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	5660 University Pkwy	Winston-Salem	NC	27105	06/15/2017	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Hospice Contact	Pharmacy Services Coordinator		Leggett	Ursula		1-919-765-4599					Ursula.Leggett@bcbsnc.com	PO Box 2291		Durham	NC	27702	02/01/2018	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Medicare Compliance Officer	VP,Comml & Medicare Compliance, Compliance Officer	Mrs.	Dreyer	Amber		1-984-960-3306					amber.dreyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	02/06/2020	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Exceptions Contact	Manager		Swanson	Ryan							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/30/2021	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active	1-888-296-9790				HMO - Health Maintenance Organization		C	Atlanta
H3449	Pharmacy Network Management Contact	AVP, Pharmacy Government Programs		Geter	Joseph		1-919-765-7733					joseph.geter@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/17/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							bret.schultz@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/14/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active	1-877-277-7893				HMO - Health Maintenance Organization		C	Atlanta
H3449	Plan to Plan Reconciliation Contact	Manager, Financial Accounting & Reporting		Hitchcock	Grace		1-919-765-7999					grace.hitchcock@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	PO Box 30060 Mailstop 700-1AP	Durham	NC	27702	12/29/2021	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3464	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/05/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H3464	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3464	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H3464	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3467	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/23/2019	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Chief Financial Officer	Chief Financial Officer, ProCare Advantage	Mr.	Hladky	Sean		1-212-758-4311	117				shladky@lbbelon.com	430 Park Avenue	7th Floor	New York	NY	10022	02/02/2022	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/07/2019	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Medicare Compliance Officer	Medicare Compliance Officer, ProCare Advantage	Ms	Vasto	Nancy		1-214-954-4114	114				nroht@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	05/06/2022	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/15/2021	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Dallas
H3467	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/15/2021	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Dallas
H3467	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3471	Automated TrOOP Balance Transfer Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Best Available Evidence Contact	Medicare Enrollment Manager		Kirby	Rae		1-217-902-9108					Rae.Kirby@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	11/29/2021	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Chief Financial Officer	Chief Financial Officer	Mr.	Bradford	Jerry		1-217-902-9002				1-217-902-9740	Jerry.Bradford@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	10/18/2021	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	CMS Casework Communication Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Coordination of Benefits Contact	Director of Claims & Recovery		Parker	Lisa		1-217-902-8353				1-217-902-9786	lisa.parker@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Customer Service Operations Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Government Relations Contact	CEO		Madigan	Sinead		1-217-902-8301				1-217-902-9740	sinead.madigan@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Hospice Contact	Director of Pharmacy		Buhr	Aimee		1-217-902-9366				1-217-902-9798	Aimee.Buhr@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	11/29/2021	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Medicare Compliance Officer	VP, Chief Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Part D Exceptions Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active	1-217-902-8224				HMO - Health Maintenance Organization		C	Chicago
H3471	Pharmacy Network Management Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3471	Pharmacy Technical Help Desk Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active	1-844-265-1876				HMO - Health Maintenance Organization		C	Chicago
H3471	Plan to Plan Reconciliation Contact			Tizora	Elizabeth		1-217-902-9469					elizabeth.tizora@healthalliance.org	3310 Fields South Dr		Champaign	IL	61822	03/14/2019	2023	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Local CCP	Health Alliance Northwest	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3473	Automated TrOOP Balance Transfer Contact	Director, PACE Finance		Hewitt	Jessica		1-720-974-6767					jhewitt@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	09/28/2021	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-303-869-4664				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/13/2021	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	Chief Financial Officer	CFO	Ms.	Gutierrez	Barbara		1-303-869-4664	0				bgutierrez@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	11/04/2018	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-720-789-6054				1-303-996-1600	epeak@myinnovage.com	750 E 6th St		Richmond	VA	23224	03/02/2021	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-303-869-4664	0				lbrown2@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/14/2020	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	Customer Service Operations Contact	COO		Boswell	Silvia		1-215-951-4433					sboswell@myinnovage.com	6970 Germantown Ave		Philadelphia	PA	19119	09/28/2021	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	Government Relations Contact	Executive VP Government Relations		Steckel	Carol		1-720-789-6157				1-303-996-1600	CSteckel@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/26/2022	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	Medicare Compliance Officer	VP of Pharmacy Services	Ms	Chase	Darla		1-720-974-6785					dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	Part D Exceptions Contact	VP of Pharmacy Services	Ms.	Chase	Darla							dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Philadelphia
H3473	Pharmacy Network Management Contact	VP of Pharmacy Services	Ms.	Chase	Darla		1-720-974-6785					dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3473	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Ms.	Chase	Darla							dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Philadelphia
H3473	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-303-869-4664				1-720-917-3390	AKizewski@myinnovAge.com	8950 East Lowry Blvd		Denver	CO	80230	05/13/2021	2023	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H3493	Automated TrOOP Balance Transfer Contact	Finance Director	Ms	Ruprecht	Janice	K	1-856-675-3643				1-856-675-3659	jruprecht@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	01/16/2019	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	Best Available Evidence Contact	Finance Director	Ms	Ruprecht	Janice	K	1-856-675-3643				1-856-675-3659	jruprecht@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	01/16/2019	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	Chief Financial Officer	Executive Director	Sr.	Sullivan	Margaret		1-856-675-3663				1-856-675-3659	sullivanm@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	10/03/2022	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	CMS Casework Communication Contact	Director Quality Assurance	Mr	Singer	Vincent		1-856-675-3654				1-856-675-3666	vincent.singer@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	03/10/2020	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	Coordination of Benefits Contact	Finance Director	Ms	Ruprecht	Janice	K	1-856-675-3643				1-856-675-3659	jruprecht@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	01/16/2019	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	Customer Service Operations Contact	Director Quality Assurance	Mr	Singer	Vincent		1-856-675-3654				1-856-675-3666	vincent.singer@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	03/10/2020	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	Government Relations Contact	Executive Director	Sr	Sullivan	Margaret		1-856-675-3663				1-856-675-3659	sullivanm@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	01/17/2019	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/22/2020	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	Part D Exceptions Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 South Broad Street		Philadelphia	PA	19145	12/31/2020	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	New York
H3493	Pharmacy Network Management Contact	Finance Director	Ms	Ruprecht	Janice	K	1-856-675-3643				1-856-675-3659	jruprecht@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	01/16/2019	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3493	Pharmacy Technical Help Desk Contact	Medical Records/IT	Ms	Lawson	Jacqueline						1-856-675-3659	lawsonj@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	04/23/2019	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active	1-856-675-3660				PACE - Nat		C	New York
H3493	Plan to Plan Reconciliation Contact	Finance Director	Ms	Ruprecht	Janice	K	1-856-675-3643				1-856-675-3659	jruprecht@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	01/16/2019	2023	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3499	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H3499	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3499	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H3499	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3517	Automated TrOOP Balance Transfer Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		1-707-443-9747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	Best Available Evidence Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		1-707-443-9747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	Chief Financial Officer	Director of Finance	Ms	Simpson	Cindy		1-707-443-9747	1214			1-707-443-3498	csimpson@humsenior.org	1910 California St		Eureka	CA	95501	02/27/2017	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	CMS Casework Communication Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		1-707-443-9747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	Coordination of Benefits Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		1-707-443-9747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	Customer Service Operations Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		1-707-443-9747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	Government Relations Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		1-707-443-9747	3221			1-707-269-1332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	Medicare Compliance Officer	Quality Assurance Manager	Mr	Kamrud	Leif		1-707-443-9747	3231			1-707-269-1332	lkamrud@humsenior.org	1910 California Street		Eureka	CA	95501	08/04/2022	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	Part D Exceptions Contact	Client support Supervisor		Slowiak	Andrea							aslowiak@pharmastarpbm.com	PO Box  3127		Eau Claire	WI	54702	12/20/2013	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active	1-888-298-7770				PACE - Nat		C	San Francisco
H3517	Pharmacy Network Management Contact	Client support Supervisor		Slowiak	Andrea		1-715-852-2983					aslowiak@pharmastarpbm.com	PO Box  3127		Eau Claire	WI	54702	12/20/2013	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3517	Pharmacy Technical Help Desk Contact	Client support Supervisor		Slowiak	Andrea							aslowiak@pharmastarpbm.com	PO Box  3127		Eau Claire	WI	54702	12/20/2013	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active	1-888-298-7770				PACE - Nat		C	San Francisco
H3517	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Simpson	Cindy		1-707-443-9747	1214			1-707-443-3498	csimpson@humsenior.org	1910 California Street		Eureka	CA	95501	09/18/2020	2023	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active					PACE - Nat		C	San Francisco
H3522	Automated TrOOP Balance Transfer Contact	Director		Werner	Ashley		1-765-935-8958					ashley.werner@reidhealth.org	2300 National Road West		Richmond	IN	47374	05/18/2021	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	Best Available Evidence Contact	Vice President Continuum of Care		Kester	Billie		1-765-983-3314					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	Chief Financial Officer		CFO	Knight	Chris		1-765-983-3225					chris.knight@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	CMS Casework Communication Contact	QA Manager		Nesbitt	Renee		1-765-935-8959	2886				renee.nesbitt@reidhealth.org	2300 National Road West		Richmond	IN	47374	01/19/2021	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	Coordination of Benefits Contact	Director		Werner	Ashley		1-765-935-8958	17906				ashley.werner@reidhealth.org	2300 National Road West		Richmond	IN	47374	05/18/2021	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	Customer Service Operations Contact	Director		Werner	Ashley		1-765-935-8958					ashley.werner@reidhealth.org	2300 National Road West		Richmond	IN	47374	01/19/2021	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	Government Relations Contact	Vice President Continuum of Care		Kester	Billie		1-765-983-3314					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	Medicare Compliance Officer	Director of Audit Services	CCO	Bierman	Randall		1-765-983-3418					randall.bierman@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	Part D Exceptions Contact	Director		Werner	Ashley							ashley.werner@reidhealth.org	2300 National Road West		Richmond	IN	47374	01/19/2021	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active	1-765-935-8958				PACE - Nat		C	Chicago
H3522	Pharmacy Network Management Contact	Director		Werner	Ashley		1-765-935-8958					ashley.werner@reidhealth.org	2300 National Road West		Richmond	IN	47374	01/19/2021	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3522	Pharmacy Technical Help Desk Contact	Director		Werner	Ashley							ashley.werner@reidhealth.org	2300 National Road West		Richmond	IN	47374	01/19/2021	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active	1-765-935-8958	3314			PACE - Nat		C	Chicago
H3522	Plan to Plan Reconciliation Contact	Director		Werner	Ashley		1-765-935-8958					ashley.werner@reidhealth.org	2300 National Road West		Richmond	IN	47374	05/18/2021	2023	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active					PACE - Nat		C	Chicago
H3528	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		1-860-674-5780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	06/25/2021	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Best Available Evidence Contact	Manager, Vendor Operations		Ewen	Jillian		1-860-674-5780					jewen@connecticare.com	175 Scott Swamp Road	P.O. Box 4050	Farmington	CT	06034-4050	03/23/2020	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		1-646-447-6174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	07/02/2020	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	CMS Casework Communication Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	1-646-447-7215				1-212-510-8130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	07/22/2022	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Coordination of Benefits Contact	Director, Medicare Regulatory Ops		Caracappa	Lisa		1-646-447-7749					lcaracappa@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2022	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Customer Service Operations Contact	VP, Ops Strategy & Service Delivery		Pandey	Priyank		1-646-447-7543					ppandey@emblemhealth.com	55 Water Street		New York	NY	10041	02/17/2021	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Government Relations Contact	Director, Medicare Compliance		Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	07/29/2019	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Hospice Contact	Senior Medicare Pharmacy Specialist		Der Weer	J'Nisha		1-646-447-7198					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2022	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/08/2019	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Exceptions Contact	Director		Colby	Andrew							acolby@emblemhealth.com	55 Water street		New York	NY	10041	05/12/2022	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	1-646-447-3340				HMO - Health Maintenance Organization		C	New York
H3528	Pharmacy Network Management Contact	Pharmacy Client Ops Director		Brown	Gregory		1-401-525-1683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2022	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	6625 West 78th street		Bloomington	MN	55439	01/24/2022	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	1-800-922-1557	2			HMO - Health Maintenance Organization		C	New York
H3528	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		1-646-447-3017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	08/16/2022	2023	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3533	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H3533	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3533	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H3533	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H3536	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H3536	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3536	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H3536	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3554	Automated TrOOP Balance Transfer Contact	Eligibility Supervisor		White	William		1-612-777-6736					eobp2p@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	02/06/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Best Available Evidence Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Chief Financial Officer	CFO	Mr.	Winter	Scott		1-501-399-3951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/06/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	CMS Casework Communication Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Coordination of Benefits Contact	Eligibility Supervisor		White	William		1-612-777-6736					cobmedd@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	02/06/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Customer Service Operations Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Government Relations Contact	Sr Counsel Gov't Relation		Fenton	Janie		1-501-378-2103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/06/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		1-501-378-3743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Fenske	Anjenette		1-501-244-6350					amfenske@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/02/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Part D Exceptions Contact			Review Audit & Regul	Clinical						1-800-693-6703	clinicalreviewclientinquiries@primetherapeutics.co	Centennial Crossings - Clinical Review 4401 West 76th S		Edina	MN	55435	02/06/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active	1-800-693-6651				PPO - BBA		C	Dallas
H3554	Pharmacy Network Management Contact	Senior Director Network Provider Relations		Grindsteinner	Bretta		1-612-777-4021					bgrinsteinner@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	02/06/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3554	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	Prime						1-888-285-2242	MGarzarodriguez@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	02/06/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active	1-800-693-3815				PPO - BBA		C	Dallas
H3554	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		1-501-399-3958				1-501-378-3258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	02/06/2020	2023	USABLE PPO INSURANCE COMPANY	Local CCP	Arkansas Blue Medicare	Local PPO		USAble Mutual Insurance Company	421	Yes	Active					PPO - BBA		C	Dallas
H3557	Automated TrOOP Balance Transfer Contact	Director PBM Operations		Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/23/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Best Available Evidence Contact	Mng Dir Operations - Medicare Segment, Enrollment		Wisniewski	Ivona		1-401-459-1721				1-401-459-5649	ivona.wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/14/2019	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Chief Financial Officer	CFO	Mr.	Stewart	Mark		1-401-459-5886				1-401-459-1290	mark.stewart@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/14/2019	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	CMS Casework Communication Contact	Director, GAU		Antunes	Kathy		1-401-459-5136				1-401-459-5668	kathy.antunes@bcbsri.org	500 Exchange Street		Providence	RI	02903	09/23/2021	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Coordination of Benefits Contact	Director PBM Operations		Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/23/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Customer Service Operations Contact	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		1-401-459-1721				1-401-459-5089	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/14/2019	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Government Relations Contact	SVP Government Programs		Pitney	Christina		1-401-459-1103					christina.pitney@bcbsri.org	500 Exchange Street		Providence	RI	02903	04/12/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Hospice Contact	Associate Director, Senior Market Enrollment		Peixoto	Kayla		1-774-955-9918					kayla.peixoto@bcbsri.org	50 Jordan Street		East Providence	RI	02914	10/04/2021	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Pennypacker	Regan		1-401-743-0003				1-401-459-1598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	04/12/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Part D Exceptions Contact	Regulatory Director		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/23/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active	1-800-693-6651				PPO - BBA		C	Boston
H3557	Pharmacy Network Management Contact	VP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	Marci.Conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/23/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3557	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/12/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active	1-855-457-1207				PPO - BBA		C	Boston
H3557	Plan to Plan Reconciliation Contact	Sr. Health Data Analyst		Simas	Heather		1-401-459-5286				1-401-459-1198	heather.simas@bcbsri.org	PO Box 1057		Providence	RI	02901	12/13/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	Local PPO		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					PPO - BBA		C	Boston
H3561	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H3561	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3561	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H3561	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3563	Automated TrOOP Balance Transfer Contact	QI and Compliance Director	Ms.	Kannan	Kannamma		1-760-280-2232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	Best Available Evidence Contact	Executive Director		Smith	RENATA		1-760-280-2230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	Chief Financial Officer	Director of Business & Finance	Mr.	Jensen	Robin	J	1-619-807-4447					rjensen@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	CMS Casework Communication Contact	Executive Director		Smith	RENATA		1-760-280-2230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	Coordination of Benefits Contact	Business and Finance Director		Jensen	Robin		1-619-807-4447					rjensen@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	Customer Service Operations Contact	Executive Director		Smith	RENATA		1-760-280-2230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	Government Relations Contact	Executive Director		Smith	RENATA		1-760-280-2230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	Medicare Compliance Officer	QI and Compliance Director	Mrs.	Kannan	Kannamma		1-760-280-2232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	Part D Exceptions Contact	Medical Director	Dr.	Colt	Ross							rcolt@westpace.org	Descanso Ave		San Marcos	CA	92078	10/01/2019	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active	1-800-920-7098				PACE - Nat		C	San Francisco
H3563	Pharmacy Network Management Contact	Medical Director	Dr.	Colt	Ross		1-760-280-2237					rcolt@westpace.org	Descanso Ave		San Marcos	CA	92078	10/01/2019	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3563	Pharmacy Technical Help Desk Contact	Medical director	Dr.	Colt	Ross							rcolt@westpace.org	Descanso Ave		San Marcos	CA	92078	06/12/2019	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active	1-800-920-7098				PACE - Nat		C	San Francisco
H3563	Plan to Plan Reconciliation Contact	Business and Finance Director		Jensen	Robin		1-619-807-4447					rjensen@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2023	GARY AND MARY WEST SENIOR SERVICES, INC.	National PACE	Gary and Mary West PACE	National PACE		Gary and Mary West Senior Services, Inc.	714	Yes	Active					PACE - Nat		C	San Francisco
H3597	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/06/2019	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3597	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3597	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3597	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3613	Automated TrOOP Balance Transfer Contact	Director of Finance	Ms.	Macartney	Lisa		1-216-851-8200	2011				lisa.macartney@mcgregoramasa.org	14900 Private Dr		Cleveland	OH	44112	02/18/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Best Available Evidence Contact	Director of Finance	Ms.	Macartney	Lisa		1-216-851-8200	2011				lisa.macartney@mcgregoramasa.org	14900 Private Dr		Cleveland	OH	44112	02/18/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Chief Financial Officer	CFO	Ms.	Hayes	Jennifer	L	1-216-851-8200	2010				jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	08/09/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	CMS Casework Communication Contact	Quality Director	Ms.	Miller	Elizabeth		1-216-791-3580					elizabeth.miller@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	02/15/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Coordination of Benefits Contact	Director of Finance	Ms.	Macartney	Lisa		1-216-851-8200	2011			1-216-851-6634	lisa.macartney@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/15/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Customer Service Operations Contact	Quality Director	Ms.	Miller	Elizabeth		1-216-791-3580					elizabeth.miller@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	02/15/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Government Relations Contact	CEO	Ms.	Conn	Ann		1-216-851-8200	2050				ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/18/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Medicare Compliance Officer	Compliance Officer	Ms.	Monroe	Mary		1-216-337-4893					mary.monroe@mcgregoramasa.org	26310 Emery Road		Warrensville Heights	OH	44128	08/09/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Part D Exceptions Contact	Director of Finance	Ms.	Macartney	Lisa						1-216-851-6634	lisa.macartney@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/15/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active	1-216-851-8200	2011			PACE - Nat		C	Chicago
H3613	Pharmacy Network Management Contact	Medical Director		Degolia	Peter		1-216-844-3791					Peter.DeGolia@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	04/03/2016	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Pharmacy Technical Help Desk Contact	CSO	Ms.	Dicesare	Svetlana							lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	02/18/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active	1-216-791-3580				PACE - Nat		C	Chicago
H3613	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Macartney	Lisa		1-216-851-8200	2011			1-216-851-6634	lisa.macartney@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/15/2022	2023	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3632	Automated TrOOP Balance Transfer Contact			Bean	Danielle		1-952-992-2864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Best Available Evidence Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Chief Financial Officer		Ms	Quist	Mary		1-952-992-2058					mary.quist@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	CMS Casework Communication Contact			Sikorski	TJ		1-952-992-8542				1-952-992-8492	thomas.sikorski@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/04/2023	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Coordination of Benefits Contact			Vilendrer	Krista		1-952-992-3252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Customer Service Operations Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Government Relations Contact			Kinsella	Ann		1-952-992-3832					ann.kinsella@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/21/2021	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Hospice Contact			Bourdages	Kathy		1-952-992-3653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/15/2019	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Medicare Compliance Officer		Mrs	Koranteng	Milly		1-952-992-2090					mildred.koranteng@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/22/2020	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/15/2019	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	1-952-992-2353				PPO - BBA		C	Kansas City
H3632	Pharmacy Network Management Contact			Dornbrook-Lavender	Kimberly		1-952-992-3448					kimberly.dornbrook-lavender@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3632	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	La Tasha							LaTasha_Monroe@expressscripts.com	13051 N. Telecom Pkwy		Temple Terrace	FL	33637	11/17/2021	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	1-800-922-1557				PPO - BBA		C	Kansas City
H3632	Plan to Plan Reconciliation Contact			Cameron	Andrew		1-952-992-2386					Andrew.Cameron@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	11/12/2021	2023	MEDICA COMMUNITY HEALTH PLAN	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H3653	Automated TrOOP Balance Transfer Contact	Analyst	Mr.	Klatt	Donni		1-419-887-2940				1-419-887-2020	Donni.Klatt@ProMedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	08/09/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Best Available Evidence Contact	Analyst	Mr.	Klatt	Donni		1-419-887-2917				1-419-887-2040	Donni.Klatt@ProMedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	08/09/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Chief Financial Officer	Chief Financial Officer	Mr.	Martin	Jeff		1-419-887-2959				1-419-887-2031	jeff.martin@promedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	05/25/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	CMS Casework Communication Contact	Member Services Team Leader	Ms.	Harper	Leslie		1-419-887-2410				1-419-887-2047	leslie.harper@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	05/25/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Coordination of Benefits Contact	Director Risk Adjustment & Recoveries	Ms.	Curry	Deborah		1-419-887-2215				1-419-887-2398	Deborah.Curry@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	08/25/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Customer Service Operations Contact	Operations Manager, Member Services	Ms.	Trivedi	Kyle		1-419-887-2424				1-419-887-2047	kyle.trivedi@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	05/25/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Government Relations Contact	Manager, Regulatory Affairs	Ms.	Beadle	Nicole		1-419-887-2859				1-419-887-2011	nicole.beadle@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	06/03/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Hospice Contact	Pharmacy Regulatory Compliance Coordinator	Mr.	Ingman	Brian		1-419-887-2204				1-567-585-9454	Brian.Ingman@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	12/28/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Medicare Compliance Officer	Manager, Regulatory Affairs	Ms.	Beadle	Nicole		1-419-887-2859				1-419-887-2011	nicole.beadle@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	06/03/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Exceptions Contact	Senior Pharmacist	Mr.	Bogner	Craig	M					1-567-585-9454	craig.bogner@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	06/06/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active	1-800-462-3589				HMO - Health Maintenance Organization		C	Chicago
H3653	Pharmacy Network Management Contact	Senior Pharmacist	Mr.	Bogner	Craig	M	1-419-887-2249				1-567-585-9454	craig.bogner@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	06/13/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Pharmacy Technical Help Desk Contact	Manager, Vendor Management	Mr.	Palmieri	Mike							Mike.Palmieri@Caremark.com	2401 Cherahala Blvd		Knoxville	TN	37932	06/02/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H3653	Plan to Plan Reconciliation Contact	Sr. Analyst	Mr.	Elliott	Sean		1-419-887-2922				1-419-887-2020	Sean.Elliott@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	06/13/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H3655	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H3655	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Automated TrOOP Balance Transfer Contact			Zlotkus	Steve		1-858-790-5873				1-858-790-6052	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/29/2020	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Best Available Evidence Contact	Manager, Eligibility & Billing	Ms	Eberhart	Karla		1-330-996-8679				1-330-996-8726	medicareeligbill@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	07/13/2021	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Chief Financial Officer	CFO	Mr.	Fehlner	Alan		1-330-996-8565				1-330-996-8454	fehlnera@summacare.com	1200 East Market Stree	Ste 400	Akron	OH	44305	08/03/2020	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	CMS Casework Communication Contact	Compliance Coordinator		Donnenwirth	Terry		1-330-996-5605				1-330-996-8726	donnenwirtht@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	02/02/2022	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Coordination of Benefits Contact	Manager,Medicare eligibility		Eberhart	Karla		1-330-996-8679				1-330-996-8726	eberhartk@summacare.com	1200 East Market Street, Ste 400	P.O. Box 3620	Akron	OH	44305	08/03/2020	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Customer Service Operations Contact	Director, Customer Services		Elerick	Christine		1-330-996-8419					elerickc@summacare.com	1077 Gorge Boulevard		Akron	OH	44310	01/24/2020	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Government Relations Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	1-440-915-2569				1-330-996-8726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Hospice Contact	Pharmacy Director		Swartz	Tiffanie		1-330-996-5651				1-330-996-8580	swartzt@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Medicare Compliance Officer	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	1-440-915-2569				1-330-996-8726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/16/2022	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Exceptions Contact	Director, PA Services		Grondin	Don						1-858-790-6529	Don.grondin@medimpact.com	10680 Treena Street	Stop 5	San Diego	CA	92131	01/17/2012	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active	1-858-790-6536				HMO - Health Maintenance Organization		C	Chicago
H3660	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148				1-858-790-6011	Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/06/2013	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Pharmacy Technical Help Desk Contact	Director, Contact Center Services		Battle	Dorry						1-858-790-6075	Dorry.battle@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/06/2013	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active	1-877-391-1109				HMO - Health Maintenance Organization		C	Chicago
H3660	Plan to Plan Reconciliation Contact	Director, Accounting	Mr.	O'Neill	Mike		1-330-996-8565				1-330-996-8454	o'neillm@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2023	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Automated TrOOP Balance Transfer Contact	Medicare Part D Supervisor		Schrock	Ranada		1-330-363-3132					rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Best Available Evidence Contact	Enrollment Coordinator		Palmer	Laura		1-330-363-4149					lpalmer@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Chief Financial Officer	Sr Vice-President	Ms.	Reagan	Andrea		1-330-363-3325				1-330-438-2911	areagan@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/20/2021	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	CMS Casework Communication Contact	Compliance Officer		Lab	Kari		1-330-363-2022				1-330-363-3066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Coordination of Benefits Contact	Medicare Part D Supervisor		Schrock	Ranada		1-330-363-3132				1-330-580-6764	rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Customer Service Operations Contact	Customer Service Supervisor		Bowling-Shaffer	Lisa		1-330-363-2206				1-330-363-7714	lbowling-shaffer@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Government Relations Contact	Compliance Officer		Lab	Kari		1-330-363-3199				1-330-363-3066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Hospice Contact	Medicare Part D Supervisor		Schrock	Ranada		1-330-363-3132				1-330-580-6764	rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Medicare Compliance Officer	Compliance Officer	Mrs	Lab	Kari		1-330-363-2022				1-330-363-3066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Part D Exceptions Contact	Medicare Part D Supervisor		Schrock	Ranada							rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active	1-800-577-5084	2248			HMO - Health Maintenance Organization		C	Chicago
H3664	Pharmacy Network Management Contact	Compliance Officer		Lab	Kari		1-330-363-2022				1-330-363-3066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Pharmacy Technical Help Desk Contact	Medicare Part D Supervisor		Schrock	Ranada							rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active	1-866-868-2373				HMO - Health Maintenance Organization		C	Chicago
H3664	Plan to Plan Reconciliation Contact	Reconciliation Analyst		David	Darrin		1-330-705-7988					ddavid@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2023	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		1-614-546-3183				1-614-546-3131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		1-614-546-3222				1-614-546-3148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		1-614-546-3211				1-614-546-3131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	CMS Casework Communication Contact	Compliance Specialist	Mr.	Jordan	David	A	1-614-706-8474				1-614-234-8372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Customer Service Operations Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		1-614-546-3180				1-614-546-3132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Government Relations Contact	CEO	Mr	Randolph	John	C	1-614-546-3152				1-614-546-3131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		1-412-478-0244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Part D Exceptions Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	1-800-240-3851				HMO - Health Maintenance Organization		C	Chicago
H3668	Pharmacy Network Management Contact	Director, Pharmacy	Mr	Turoff	Chris		1-614-403-0394					chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H3668	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3672	Automated TrOOP Balance Transfer Contact	Clinical Pharmacist		Hill	Brendal		1-865-256-5940				1-304-885-7592	bhill@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/25/2022	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Best Available Evidence Contact	Manager Medicare Operations		Panas	Lori		1-740-699-6208				1-740-699-6164	lorip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	01/10/2018	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Chief Financial Officer	Chief Financial Officer	Mr	Ralston	Ryan		1-740-699-6236				1-740-699-6161	rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/13/2019	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	CMS Casework Communication Contact	Director Medicare Operations		Richard	Penny		1-740-695-7597				1-740-699-6163	PennyR@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/18/2021	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Coordination of Benefits Contact	Manager COB		Fetty	Jackie		1-740-695-7699				1-740-699-6163	jfetty@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/06/2019	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Customer Service Operations Contact	Director Medicare Operations		Richard	Penny		1-740-695-7597				1-740-699-6163	PennyR@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/18/2021	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Government Relations Contact	Gov't Compliance Officer	Ms	Medley	Jill		1-740-695-7693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/20/2020	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Hospice Contact	Manager, Pharmacy Compliance		Johnson	Chasity		1-740-359-8592				1-304-885-7592	ChasityJ@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	04/27/2021	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Medicare Compliance Officer	Gov't Compliance Officer	Ms	Medley	Jill		1-740-695-7693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/20/2020	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Part D Exceptions Contact	Clinical Pharmacist		Hill	Brendal						1-304-885-7592	bhill@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/25/2022	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active	1-800-624-6961	6627			HMO - Health Maintenance Organization		C	Philadelphia
H3672	Pharmacy Network Management Contact	Network Account Dir, Retail Strategy & Contracting		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	10/19/2016	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3672	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	Express Scripts	13051 N. Telecom PKWY STE 150	Temple Terrace	FL	33637	11/18/2021	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Philadelphia
H3672	Plan to Plan Reconciliation Contact	Controller		Marsh	Jane		1-740-699-6121				1-740-699-6161	jmarsh@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/30/2018	2023	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3706	Automated TrOOP Balance Transfer Contact	VP, Pharmacy		Patel	Monank		1-813-468-3605					monank.patel@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102	08/09/2022	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Best Available Evidence Contact	Manager, Eligibility & Enrollment		Rhodes	Trent		1-405-280-5871					trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	04/20/2022	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Chief Financial Officer	Vice President, Finance	Ms.	Harris	Tayla		1-405-280-5724					tayla.harris@globalhealth.com	210 Park Ave	Suite 2800	Oklahoma City	OK	73102	06/25/2021	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	CMS Casework Communication Contact	Senior Director, Compliance		Akins	Monique	S	1-405-280-5741					monique.akins@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	12/01/2022	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Coordination of Benefits Contact	Manager, Eligibility & Enrollment		Rhodes	Trent		1-405-280-5871					trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	04/20/2022	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Customer Service Operations Contact	Director, Customer Care		Thomas	Daniel		1-405-280-5626					Daniel.Thomas@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	06/17/2021	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Government Relations Contact	VP, Compliance & Legal		Kabuci	Lauren		1-405-280-5220					lauren.kabuci@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	10/26/2022	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Hospice Contact	VP, Health Services		Stouffer	Kelly		1-405-280-5608					kelly.stouffer@globalhealth.com	6120 S. Yale Avenue	Suite 925	Tulsa	OK	74136	07/19/2021	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Medicare Compliance Officer	Senior Director, Compliance	Ms.	Akins	Monique		1-405-280-5741					monique.akins@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	10/26/2022	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Part D Exceptions Contact	VP, Pharmacy		Patel	Monank							monank.patel@globalhealth.com	6120 S Yale Avenue	Suite 925	Tulsa	OK	74136	08/18/2021	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	1-813-468-3605				HMO - Health Maintenance Organization		C	New York
H3706	Pharmacy Network Management Contact	VP, Pharmacy		Patel	Monank		1-813-468-3605					monank.patel@globalhealth.com	6120 S Yale Avenue	Suite 925	Tulsa	OK	74136	08/18/2021	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3706	Pharmacy Technical Help Desk Contact	VP, Pharmacy		Patel	Monank							monank.patel@globalhealth.com	6120 S Yale Avenue	Suite 925	Tulsa	OK	74136	08/18/2021	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H3706	Plan to Plan Reconciliation Contact	VP, Finance		Harris	Tayla		1-405-280-5724					tayla.harris@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	10/30/2019	2023	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3708	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/18/2020	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H3708	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-844-633-1063				HMO - Health Maintenance Organization		C	Dallas
H3708	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3727	Automated TrOOP Balance Transfer Contact	CFO	Mr	Heimgartner	Jeremy		1-513-469-8545				1-513-605-6845	jheimgartner@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/27/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Best Available Evidence Contact	Director Health Plan Operations	Ms	Torrey	Heather		1-513-469-8546				1-513-605-6830	htorrey@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/24/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Chief Financial Officer	CFO	Mr	Heimgartner	Jeremy		1-513-469-8545				1-513-605-6845	jheimgartner@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/27/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	CMS Casework Communication Contact	CMO	Dr	Schlageck	Joe		1-513-469-8549				1-513-605-6845	jschlageck@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/27/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Coordination of Benefits Contact	CFO		Heimgartner	Jeremy		1-513-469-8545				1-513-605-6845	jheimgartner@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/27/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Customer Service Operations Contact	Director Health Plan Operations	Ms	Torrey	Heather		1-513-469-8546				1-513-605-6845	htorrey@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/24/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Government Relations Contact	COMPLIANCE OFFICER	Mr	Guzman	Fabian		1-513-240-4810				1-513-605-6845	fguzman@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/28/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Hospice Contact	CMO	Dr	Schlageck	Joe		1-513-469-8549				1-513-605-6845	jschlageck@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/28/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Medicare Compliance Officer	Chief Compliance Officer	Mr	Guzman	Fabian		1-513-240-4810				1-513-605-6845	fguzman@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/28/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Part D Exceptions Contact	AVP Clinical Operations	MS	Lavignette	Amanda						1-330-486-4801	alavignette@elixirsolutions.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	01/20/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Chicago
H3727	Pharmacy Network Management Contact	Director Pharmacy Network Development and Operatio		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/08/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Pharmacy Technical Help Desk Contact	Elixir VP Operations		Conn	Todd							tconn@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/20/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	1-833-697-8516				HMO - Health Maintenance Organization		C	Chicago
H3727	Plan to Plan Reconciliation Contact	CFO	Mr	Heimgartner	Jeremy		1-513-469-8545				1-513-605-6845	jheimgartner@communicare-advantage.com	10123 Alliance Road		Blue Ash	OH	45242	10/28/2022	2023	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3748	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/10/2018	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/06/2019	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3748	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3748	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3748	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3749	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/05/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H3749	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3749	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H3749	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3755	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Services		Perez	Charles		1-918-594-5295	6479				cperez@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/06/2017	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Best Available Evidence Contact	Supervisor, Medicare Enrollment		East	Shawn		1-918-594-5295	6903				seast@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/06/2017	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Chief Financial Officer	SR VP & CFO	Mr.	Butcher	Jeffrey		1-918-594-5295	5308				jbutcher@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	08/16/2021	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	CMS Casework Communication Contact	Supervisor, Pharmacy Services		Burke	Amy		1-918-594-5295	6808			1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Coordination of Benefits Contact	Supervisor, Claims		Higgins	Susan		1-918-594-5295	6401				coordinationofbenefits@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	09/21/2022	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Customer Service Operations Contact	VP Operations		White	Sherrie		1-918-594-5295	5386				swhite@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Government Relations Contact	VP Chief Risk & Compliance Officer		Hill	Andrew		1-918-594-5295	4055				ahill@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	08/16/2021	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Hospice Contact	Supervisor, Pharmacy Services		Burke	Amy		1-918-594-5295	6808			1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Medicare Compliance Officer	VP Chief Risk & Compliance Officer	Mr.	Hill	Andrew		1-918-594-5295	4055				ahill@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	08/16/2021	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Part D Exceptions Contact	Supervisor, Pharmacy Services		Burke	Amy						1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	1-877-293-8628	6808			HMO - Health Maintenance Organization		C	Dallas
H3755	Pharmacy Network Management Contact	Manager, Pharmacy Services		Perez	Charles		1-918-594-5295	6479				cperez@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	04/24/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3755	Pharmacy Technical Help Desk Contact	Supervisor, Pharmacy Services		Burke	Amy						1-918-794-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	1-877-293-8628	6808			HMO - Health Maintenance Organization		C	Dallas
H3755	Plan to Plan Reconciliation Contact	Senior Financial Analyst		Mack	Lynda		1-918-594-5295	6320				lmack@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	03/10/2020	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3777	Automated TrOOP Balance Transfer Contact			Therapeutics	Prime		1-612-777-6747					eobp2@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/03/2020	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Best Available Evidence Contact	Sr. Team Leader		Morgan	Dina		1-336-201-4512					dina.morgan@bcbsnc.com	5660 University Parkway		Winston Salem	NC	27105	03/03/2020	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Chief Financial Officer	VP, Chief Accounting & Risk Officer	Ms.	O'Brien	Lauren		1-919-765-3996					lauren.o'brien@bcbsnc.com	PO Box 2291		Durham	NC	27702	08/26/2021	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	CMS Casework Communication Contact	Manager, Operations Quality & Compliance		Henderson	Nicole		1-919-765-1320					nicole.henderson@bcbsnc.com	PO Box 2291		Durham	NC	27702	03/03/2020	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Coordination of Benefits Contact	Team Lead, Claims		McGregory	Ann		1-336-201-4530					ann.mcgregory@bcbsnc.com	5660 University Parkway		Winston Salem	NC	27105	03/03/2020	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Customer Service Operations Contact			Service	Customer		1-984-364-3974					info@experiencehealthnc.com	PO Box 17509		Winston Salem	NC	27116	03/03/2020	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Government Relations Contact	Chief Compliance Officer	Ms.	Harrison	Marcia		1-919-613-8589					marcia.harrison@experiencehealthnc.com	3100 Tower Blvd	Suite 406	Durham	NC	27707	02/11/2019	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Hospice Contact	Pharmacy Services Coordinator	Ms.	Leggett	Ursula		1-919-765-4599					ursula.leggett@bcbsnc.com	PO Box 2291		Durham	NC	27702	03/02/2020	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Harrison	Marcia		1-919-613-8589					marcia.harrison@experiencehealthnc.com	3100 Tower Blvd	Suite 406	Durham	NC	27707	02/11/2019	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Exceptions Contact	Manager, Pharmacy Operations		Stalder	Brian							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	01/28/2019	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active	1-888-296-9790				HMO - Health Maintenance Organization		C	Atlanta
H3777	Pharmacy Network Management Contact	AVP, Pharmacy Government Programs		Geter	Joseph		1-919-765-7733					joseph.geter@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/01/2022	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							PharmacyOps@primetherapeutics.com	Prime Therapeutics, LLC	1305 Corporate Center Drive	Eagan	MN	55121	01/28/2019	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active	1-877-277-7893				HMO - Health Maintenance Organization		C	Atlanta
H3777	Plan to Plan Reconciliation Contact	Manager, Financial Accounting & Reporting		Hitchcock	Grace		1-919-765-7999					grace.hitchcock@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	P.O. Box 30060 Mailstop 700-1AP	Durham	NC	27702	12/29/2021	2023	EXPERIENCE HEALTH, INC.	Local CCP	Experience Health, Inc.	HMO/HMOPOS		EXPERIENCE HEALTH, INC.	693	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3794	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H3794	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3794	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H3794	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3800	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Dr	Ford	James	E	1-443-275-9801					jford@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Best Available Evidence Contact	Director of Partner Development	Ms	Radice	Sue		1-410-991-3213				1-844-462-3091	sradice@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Chief Financial Officer	CFO	Mr	Persinger	Keith		1-410-456-3946					kpersinger@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	12/29/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	CMS Casework Communication Contact	Chief Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/03/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Coordination of Benefits Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	10/23/2019	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Customer Service Operations Contact	Sr. Director of Operations	Mr.	Brain	Jay		1-240-367-2626					JBrain@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/29/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Government Relations Contact			Grindrod	Rick		1-410-424-0804					rgrindrod@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	08/17/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Hospice Contact	Account Manager	Ms.	Sousa	Ana		1-215-872-4933					asousa@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Medicare Compliance Officer	Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	11/10/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Part D Exceptions Contact	Associate Vice President	Ms	Lavignette	Amanda							alavignette@envsionrx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	11/10/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Philadelphia
H3800	Pharmacy Network Management Contact	Director Pharmacy Network Development & Operations		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3800	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-844-846-8007				HMO - Health Maintenance Organization		C	Philadelphia
H3800	Plan to Plan Reconciliation Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	10/23/2019	2023	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3805	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/26/2018	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	6220 Old Dobbin Lane		Columbia	MD	21045	03/26/2018	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/05/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H3805	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3805	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/24/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H3805	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3809	Automated TrOOP Balance Transfer Contact			Wachsmuth	Rosalie		1-503-215-3681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Best Available Evidence Contact			Wachsmuth	Rosalie		1-503-215-3681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	05/22/2019	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Chief Financial Officer	Health Plan & Finance Director	Ms.	Barr	Natalie		1-503-215-3859				1-503-215-0685	natalie.barr@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	CMS Casework Communication Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		1-503-215-3681				1-503-215-0685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Coordination of Benefits Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		1-503-215-3681				1-503-215-0685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Customer Service Operations Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		1-503-215-3681				1-503-215-0685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Government Relations Contact			Noordijk	Cindy		1-503-215-4124				1-503-215-0685	cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Medicare Compliance Officer	Compliance Officer	Ms.	Noordijk	Cindy		1-503-215-4124				1-503-215-0685	cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part D Exceptions Contact			Chambers	Perry							Perry.Chambers@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active	1-503-215-3672				PACE - Nat		C	Seattle
H3809	Pharmacy Network Management Contact			Schultz	Elizabeth		1-425-525-6908					Elizabeth.Schultz@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Pharmacy Technical Help Desk Contact			Service	Customer							Rosalie.Wachsmuth@providence.org	4515 Martin Luther King Jr Way S, Ste. 100		Seattle	WA	98108	05/02/2022	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active	1-888-445-5518				PACE - Nat		C	Seattle
H3809	Plan to Plan Reconciliation Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		1-503-215-3681				1-503-215-0685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2023	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence ElderPlace Portland	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3810	Automated TrOOP Balance Transfer Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		1-541-471-4106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Best Available Evidence Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		1-971-222-6045					amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Chief Financial Officer	CFO	Mr.	Woodin	Matthew	P	1-541-471-4106				1-541-471-1524	matthew.woodin@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/07/2022	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	CMS Casework Communication Contact	Compliance Director	Ms.	Matola	Laura		1-541-471-4106				1-541-471-1524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Coordination of Benefits Contact	Controller	Ms.	Ross	Andi	E	1-541-471-4106	5111			1-541-956-1674	andi.ross@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Customer Service Operations Contact	Chief Compliance Officer	Ms.	Ackerman	Cynthia		1-541-471-4106				1-541-471-1524	cynthia.ackerman@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Government Relations Contact	CEO	Mr.	Flow	Douglas	L	1-541-471-4106				1-541-471-1524	doug.flow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Hospice Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		1-541-471-4106					amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Ackerman	Cynthia	A	1-541-471-4106	8115			1-541-471-1524	cynthia.ackerman@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	12/02/2020	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Part D Exceptions Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy							amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active	1-888-460-0185				HMO - Health Maintenance Organization		C	Seattle
H3810	Pharmacy Network Management Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		1-541-471-4106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3810	Pharmacy Technical Help Desk Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy							amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active	1-888-460-0185				HMO - Health Maintenance Organization		C	Seattle
H3810	Plan to Plan Reconciliation Contact	Controller	Ms.	Ross	Andi	E	1-541-471-4106				1-541-471-1524	andi.ross@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2023	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Automated TrOOP Balance Transfer Contact	Director of Medicare Programs	Ms.	Severson	Denise		1-541-768-6326				1-541-768-4294	dseverson@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	10/09/2020	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Best Available Evidence Contact	Director of Financial Operations	Mr	Began	Trent		1-541-768-7993				1-541-768-4294	tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	10/09/2020	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Chief Financial Officer	Chief Executive Officer	Mr.	Butler	Bruce		1-541-768-5484				1-541-768-4294	bbutler@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/26/2019	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	CMS Casework Communication Contact	Manager - Grievance-Appeals	Ms.	Oxenhandler	Alyxus		1-541-768-5954					shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/13/2017	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Coordination of Benefits Contact	Director of Medicare Programs		Severson	Denise		1-541-768-4278				1-541-768-4294	dseverson@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	10/09/2020	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Customer Service Operations Contact	Manager of Customer Service	Mr	Taylor	Philip		1-541-768-6757				1-541-768-4294	ptaylor@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	06/03/2020	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Government Relations Contact	Director of Medicare Programs	Ms.	Severson	Denise		1-541-768-4278				1-541-768-4294	dseverson@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	10/09/2020	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Hospice Contact	Manager Pharmacy Programs		Molina	Katie		1-541-768-7145					kmolina@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	02/03/2022	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Medicare Compliance Officer	Compliance Officer	Mr.	Norman	Chris		1-541-905-4914				1-541-768-4294	chnorman@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/27/2021	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Part D Exceptions Contact	Director of Pharmacy Services		Kuffour	Nana Ama						1-541-768-4294	shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/20/2021	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active	1-541-768-4245				HMO - Health Maintenance Organization		C	Seattle
H3811	Pharmacy Network Management Contact	Director of Pharmacy Services		Kuffour	Nana Ama		1-541-768-7145				1-541-768-4294	nkuffour@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	02/03/2022	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3811	Pharmacy Technical Help Desk Contact	Manager of Pharmacy Programs		Molina	Katie						1-541-768-6828	kmolina@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	02/03/2022	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active	1-888-435-2396				HMO - Health Maintenance Organization		C	Seattle
H3811	Plan to Plan Reconciliation Contact	Manager - Fin Plan-Analysis	Mr.	Boyer	Benjamin		1-541-768-4210				1-541-768-4294	bboyer@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	08/31/2021	2023	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plan	HMO/HMOPOS		Samaritan Health Services	201	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3813	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/04/2020	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Best Available Evidence Contact	Supervisor Membership Accounting		Black	Colby		1-503-265-5606					colby.black@modahealth.com	601 SW 2nd Avenue		Portland	OR	97204	04/01/2022	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Chief Financial Officer	Sr VP CFO	Mr.	Evans	Dave		1-503-243-3952				1-503-948-5557	dave.evans@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	07/11/2018	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	CMS Casework Communication Contact	Lead Appeals Coordinator	Ms.	Shattuck	Mica		1-503-412-4021				1-833-949-1888	mica.shattuck@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/11/2020	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Coordination of Benefits Contact			Service	Customer		1-877-299-9062				1-503-948-5577	MedicalMedicare@modahealth.com	PO Box 40384		Portland	OR	97240	04/19/2022	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Customer Service Operations Contact	Customer Service Manager	Ms.	Duncan	Colleen		1-503-765-3424					colleen.duncan@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	02/11/2019	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Government Relations Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		1-503-952-5075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Hospice Contact	Rx Government Programs Analyst	Mr.	Beebe	Colin		1-503-412-4175	4175			1-800-207-8235	colin.beebe@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	06/04/2020	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	McWhorter	Gary		1-503-952-5075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Part D Exceptions Contact	Pharmacy, Customer Service		Service	Customer						1-800-207-8235	PharmacyMedicare@modahealth.com	601 S.W. Second Ave.		Portland	OR	97204	01/25/2017	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active	1-888-786-7509				PPO - BBA		C	Seattle
H3813	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@navitus.com	361 Integrity Drive		Madison	WI	53717	03/31/2022	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3813	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/22/2022	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active	1-866-270-3877				PPO - BBA		C	Seattle
H3813	Plan to Plan Reconciliation Contact	Lead Pharmacy Benefit Formulary Coordinator	Ms	Brokaw	Katie		1-503-265-4771	4771				katie.brokaw@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/22/2020	2023	MODA HEALTH PLAN, INC.	Local CCP	Moda Health Plan, Inc.	Local PPO		Moda Partners, Inc.	226	Yes	Active					PPO - BBA		C	Seattle
H3814	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		1-858-790-6445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Best Available Evidence Contact	Enrollment Manager		Vredenburg	Cristi		1-541-492-5119					Cristi.vredenburg@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	08/04/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Chief Financial Officer	Chief Financial Officer	Mr.	Desai	Roshan		1-727-251-8934				1-503-584-1772	Roshan.Desai@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	05/18/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	CMS Casework Communication Contact	Enrollment Manager		Vredenburg	Cristi		1-541-492-5119					Cristi.vredenburg@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	08/04/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Coordination of Benefits Contact	Chief Operations Officer	Ms.	Regalado	Mae		1-951-206-7316					mae.regalado@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	03/04/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Customer Service Operations Contact	Chief Operations Officer	Ms.	Regalado	Mae		1-951-206-7316					mae.regalado@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	03/04/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Government Relations Contact	Chief Compliance Officer		Flynn	Jordan		1-602-692-4381				1-503-584-1772	Jordan.flynn@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	07/08/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Hospice Contact	VP of Pharmacy Operations	Ms.	Liu	Helen		1-970-712-9377					helen.liu@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	12/08/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Flynn	Jordan		1-602-692-4381				1-503-584-1772	Jordan.flynn@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	07/08/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Part D Exceptions Contact	Director of Appeals and Grievances		Vaughn	Sara						1-541-672-8670	sara.vaughn@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	11/11/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	1-877-672-8620	3			HMO - Health Maintenance Organization		C	Seattle
H3814	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/13/2019	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3814	Pharmacy Technical Help Desk Contact	Director, Contact Center Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/08/2018	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	1-800-681-9571				HMO - Health Maintenance Organization		C	Seattle
H3814	Plan to Plan Reconciliation Contact	Chief Financial Officer		Desai	Roshan		1-727-251-8934				1-503-584-1772	Roshan.Desai@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	05/18/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3815	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/01/2020	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	06/02/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	08/25/2020	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/02/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	06/02/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/02/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/31/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	San Francisco
H3815	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	03/31/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3815	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/21/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				HMO - Health Maintenance Organization		C	San Francisco
H3815	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	11/19/2018	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H3817	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				PPO - BBA		C	Seattle
H3817	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3817	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				PPO - BBA		C	Seattle
H3817	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H3822	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Servce Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Denver
H3822	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3822	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				HMO - Health Maintenance Organization		C	Denver
H3822	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3828	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		1-614-546-3183				1-614-546-3131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		1-614-546-3222				1-614-546-3148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		1-614-546-3211				1-614-546-3131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	CMS Casework Communication Contact	Compliance Specialist	Mr.	Jordan	David	A	1-614-706-8474				1-614-234-8372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Customer Service Operations Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		1-614-546-3180				1-614-546-3132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Government Relations Contact	CEO	Mr	Randolph	John	C	1-614-546-3152				1-614-546-3131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		1-412-478-0244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Part D Exceptions Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active	1-800-240-3851				PPO - BBA		C	Chicago
H3828	Pharmacy Network Management Contact	Director, Pharmacy	Mr	Turoff	Chris		1-614-403-0394					chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3828	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active	1-866-693-4620				PPO - BBA		C	Chicago
H3828	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H3832	Automated TrOOP Balance Transfer Contact	Senior Business Analyst		Kalino	Karen		1-808-948-6262				1-808-948-6585	karen_apiki_kalino@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	11/27/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Best Available Evidence Contact	Manager, Membership Services		Makio	Lani		1-808-948-6215				1-808-948-6285	lani_makio@hmsa.com	P.O. Box 860	7 - MS	Honolulu	HI	96808	12/04/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Chief Financial Officer	EVP, Chief Financial Officer	Ms.	Marting	Gina		1-808-948-5696				1-808-948-5999	gina_marting@hmsa.com	P.O. Box 860	11 - EXEC	Honolulu	HI	96808-0860	12/23/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	CMS Casework Communication Contact	Medicare Grievance & Appeal Coordinator		Hartenstein	Renee		1-808-948-5347				1-808-952-7546	Renee_Hartenstein@hmsa.com	P.O. Box 860	KB-MAA	Honolulu	HI	96808	12/29/2021	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Coordination of Benefits Contact	Sr Mgr, Internal Operations		Shimamura	Ross		1-808-948-6294					ross_shimamura@hmsa.com	P.O. Box 860	7-CA	Honolulu	HI	96808	10/27/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Customer Service Operations Contact	Manager, Customer Relations Operations		Unger	Kevin		1-808-948-6186				1-808-948-5567	Customer-service@hmsa.com	P.O. Box 860	7 CR	Honolulu	HI	96808	10/27/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Government Relations Contact	SVP, Government		Diesman	Jennifer		1-808-561-6397				1-808-948-6860	jennifer_diesman@hmsa.com	P.O. Box 860	11 EXEC	Honolulu	HI	96808	10/27/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Hospice Contact	Business Analyst - Medicare Part D		Pagura	Herch		1-808-948-6559				1-808-948-5611	herch_pagura@hmsa.com	PO Box 860	PM - Administration	Honolulu	HI	96808	11/03/2021	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Rivad	Maila		1-808-948-5767				1-808-948-6585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	01/23/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Part D Exceptions Contact	Manager, Clinical Pharmacy		Kuniyoshi	Derek						1-808-948-8298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	12/04/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active	1-800-462-2085				PPO - BBA		C	San Francisco
H3832	Pharmacy Network Management Contact	Director		Smith	Shawn		1-480-391-4844					shawn.smith@cvshealth.com	9501 E. Shea Blvd., MC080	CVS Caremark	Scottsdale	AZ	85260	12/20/2019	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3832	Pharmacy Technical Help Desk Contact	Lead Director, Client Operations Customer Care		Neiman	Beth							Beth.Neiman@CVSHealth.com	100 Mall Blvd	CVS Specialty	Monroeville	PA	15146	11/07/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active	1-866-693-4620				PPO - BBA		C	San Francisco
H3832	Plan to Plan Reconciliation Contact	Director, Government Accounting and Reporting		Nakashima	Marla		1-808-948-6020				1-808-948-5063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H3864	Automated TrOOP Balance Transfer Contact	VP, Government Operations		Hannabach	Jane		1-541-330-2530					Jane.Hannabach@pacificsource.com	PO Box 7469		Bend	OR	97708	12/17/2021	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Best Available Evidence Contact	VP, Government Operations		Hannabach	Jane		1-541-330-2530					Jane.Hannabach@pacificsource.com	PO Box 7469		Bend	OR	97708	12/17/2021	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Chief Financial Officer	Executive VP and Chief Financial Officer (CFO)	Mr.	Davidson	Peter		1-541-684-5212				1-541-385-3008	Peter.Davidson@pacificsource.com	555 International Way		Springfield	OR	97477	09/16/2020	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	CMS Casework Communication Contact	Team Leader Appeals and Grievances		Downey	Reanna		1-541-706-5031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Coordination of Benefits Contact	Claims Manager COB-TPL		Keeler	Dena		1-541-225-3765					Dena.Keeler@pacificsource.com	555 International Way		Springfield	OR	97477	04/14/2022	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Customer Service Operations Contact	VP, Government Operations		Hannabach	Jane		1-541-330-2530				1-541-385-3008	Jane.Hannabach@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Government Relations Contact	Director, Government Compliance	Ms.	Brown	Jennifer		1-541-330-8115				1-541-385-3008	Jennifer.Brown@pacificsource.com	PO Box 7469		Bend	OR	97708	10/08/2020	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Hospice Contact	Administrative Programs Manager		Riffle	Connie		1-541-330-7309				1-541-385-3008	Connie.Riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	02/15/2018	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Medicare Compliance Officer	Compliance Manager	Mrs.	Brown	Jennifer		1-541-330-8115				1-541-385-3008	Jennifer.Brown@pacificsource.com	PO Box 7469		Bend	OR	97708	10/07/2022	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Exceptions Contact	Pharmacy Services Leadership Team		Services	Pharmacy							RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active	1-541-330-4999				HMO - Health Maintenance Organization		C	Seattle
H3864	Pharmacy Network Management Contact	SR. Manager, PBM Financial Operations		Okrie	Courtney		1-480-318-1864					Courtney.Okrie@CVSHealth.com	9501 E. Shea Blvd, MC080		Scottsdale	AZ	85620	01/06/2022	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Pharmacy Technical Help Desk Contact	Government Programs Pharmacy Services		Services	Pharmacy							pharmacyservices-government@pacificsource.com	PO Box 7469		Bend	OR	97708	04/07/2016	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active	1-888-437-7728				HMO - Health Maintenance Organization		C	Seattle
H3864	Plan to Plan Reconciliation Contact	Enrollment and Billing Representative		Yeakey	Paula		1-541-706-5172					P2Padmin@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3890	Automated TrOOP Balance Transfer Contact	AVP Pharmacy	Mr.	Fatodu	Hugh		1-410-424-4671				1-410-424-4671	fatoduh@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Best Available Evidence Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		1-863-634-1202					Sriaz@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/17/2022	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Chief Financial Officer	Chief Financial Officer	Mr.	Chojnowski	Daniel		1-207-807-2496					DChojnowski@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/19/2021	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	CMS Casework Communication Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		1-443-618-0786					MDonnelly@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/24/2020	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Coordination of Benefits Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		1-863-634-1202					Sriaz@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/17/2022	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Customer Service Operations Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		1-863-634-1202					Sriaz@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/17/2022	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Government Relations Contact	President Medicare Advantage	Ms.	Wilson	Marja		1-360-306-1205					MWilson@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/20/2021	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Hospice Contact	Medicare Part D Pharmacy Manager	Ms.	Wexler	Mary Beth		1-410-762-5938					MBWexler@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Donnelly	Mary		1-443-618-0786					MDonnelly@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/24/2020	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Part D Exceptions Contact	Director, Pharmacy	Ms.	Gazy	Nahid						1-410-762-1521	ngazy@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active	1-800-261-2396				PPO - BBA		C	Philadelphia
H3890	Pharmacy Network Management Contact	AVP Pharmacy	Mr.	Fatodu	Hugh		1-410-424-4671				1-410-424-4671	fatoduh@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3890	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Ms.	Gazy	Nahid						1-410-762-1521	ngazy@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	05/13/2019	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active	1-866-693-4620				PPO - BBA		C	Philadelphia
H3890	Plan to Plan Reconciliation Contact	AVP of Finance	Mr.	Magee	Ryan		1-410-424-4948					RMagee@jhhc.com	7231 Parkway Drive	Suite 100	Hanover	MD	21076	03/10/2022	2023	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Philadelphia
H3907	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		1-412-454-5539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		1-412-454-5559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	07/18/2016	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	CMS Casework Communication Contact	Sr. Manager, Medicare Compliance	Ms.	McGough	Amber		1-412-454-5250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2022	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		1-412-454-7664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/18/2012	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		1-412-454-8589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	08/29/2012	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active	1-800-396-4139				HMO - Health Maintenance Organization		C	Philadelphia
H3907	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	10/31/2016	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3907	Pharmacy Technical Help Desk Contact	DIrector, Customer Service		Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	07/29/2021	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Philadelphia
H3907	Plan to Plan Reconciliation Contact	Business Analyst		Michalski	Jeff		1-412-454-5715				1-412-454-2110	medicarereporting@upmc.edu	c/o UPMC Health Plan Attn: Dave Soltesz P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	10/03/2022	2023	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3908	Automated TrOOP Balance Transfer Contact	Regional Director Finance		Fuhrmeister	Nicole		1-215-778-8707					nicole/fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	10/03/2022	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Best Available Evidence Contact	Regional Director Finance		Fuhrmeister	Nicole		1-215-778-8707					nicole/fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	10/03/2022	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Chief Financial Officer	Executive Director	Ms	Crumley	Molly		1-267-787-8150					MCrumley@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	10/03/2022	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	CMS Casework Communication Contact	Chief Clinical & Compliance Officer		Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/22/2020	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Coordination of Benefits Contact	Regional Director Finance		Fuhrmeister	Nicole		1-215-778-8707					nicole/fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	10/03/2022	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Customer Service Operations Contact	Executive Director	Ms	Crumley	Molly		1-267-787-8150					MCrumley@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	04/26/2019	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Government Relations Contact	Executive Director	Ms	Crumley	Molly		1-267-787-8150					MCrumley@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	10/03/2022	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Medicare Compliance Officer	VP Clinical Operations, Nursing and Compliance	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	04/27/2018	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Part D Exceptions Contact	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 South Broad Street		Philadelphia	PA	19145	12/31/2020	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Philadelphia
H3908	Pharmacy Network Management Contact	Medical Director	Dr.	May	Kim		1-267-787-8225					kim.may@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	10/03/2022	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	May	Kim							kim.may@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/22/2020	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active	1-267-787-8225				PACE - Nat		C	Philadelphia
H3908	Plan to Plan Reconciliation Contact	Director of Finance	Mr.	Clemens	Richard		1-267-230-7207					RClemens@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	10/03/2022	2023	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3909	Automated TrOOP Balance Transfer Contact	Pharmacy Services Manager		Parisi	Dana		1-215-241-3265				1-215-241-3526	Dana.Parisi@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	02/26/2015	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Best Available Evidence Contact	Sr. Business Analyst		Caldwell	Geraldine		1-267-675-1809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Chief Financial Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		1-215-241-4614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/22/2022	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	CMS Casework Communication Contact	Manager, Medicare Operations		Zonies	Melissa		1-267-675-1633					Melissa.Zonies@ibx.com	1901 Market Street, 11th Floor		Philadelphia	PA	19103	10/18/2016	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Coordination of Benefits Contact	Manager, COB/OPL		Hawkins	Veronica		1-215-640-7507	27507				Veronica.Hawkins@ibx.com	1901 Market Street	17th Floor	Philadelphia	PA	19103	12/24/2020	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Customer Service Operations Contact	Director, Contact Center		Lentz	Michael		1-215-793-3262	63262				michael.lentz@ibx.com	1900 Market Street	5th Floor	Philadelphia	PA	19103	11/01/2022	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Government Relations Contact	Director of Regulatory Performance Management		Wyka	Tara		1-215-241-3648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Hospice Contact	Manager Pharmacy Compliance		Wells	Erika		1-215-241-3596					Erika.Wells@ibx.com	1901 Market St.	29th Floor	Philadelphia	PA	19103	11/29/2021	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Medicare Compliance Officer	Dir, Corp. Compl, Privacy & Medicare Compl Officer	Mr.	Goldberg	Mitchell		1-215-241-9516				1-215-567-4542	Mitchell.Goldberg@ibx.com	1901 Market Street		Philadelphia	PA	19103	02/28/2020	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Part D Exceptions Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						1-215-241-3526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active	1-888-678-7015				PPO - BBA		C	Philadelphia
H3909	Pharmacy Network Management Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		1-215-241-2654				1-215-241-3526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/30/2021	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3909	Pharmacy Technical Help Desk Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						1-215-241-3526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active	1-888-678-7015				PPO - BBA		C	Philadelphia
H3909	Plan to Plan Reconciliation Contact	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		1-215-640-7265				1-215-241-2408	Geoffrey.Wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	02/18/2022	2023	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Automated TrOOP Balance Transfer Contact	Manager, Enrollment & Billing	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/05/2017	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Chief Financial Officer	CFO Highmark Health Plan	Mr.	Veach	Daryl		1-412-544-7531					Daryl.Veach@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/14/2021	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	1-412-544-4579				1-717-635-4209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/06/2020	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		1-412-544-4417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	12/26/2019	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		1-814-871-6712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/30/2020	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Government Relations Contact	SVP, Government Affiars	Mr.	Warfel	Michael	G	1-717-302-3979					michael.warfel@highmark.com	1800 Center St.		Camp Hill	PA	17011	03/18/2022	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Hospice Contact	Intake Coordinator		Welker	Jessica		1-717-888-3043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	10/25/2019	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		1-412-544-7031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	11/10/2017	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/08/2022	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active	1-800-344-3405	733326			PPO - BBA		C	Philadelphia
H3916	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3916	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/08/2022	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active	1-800-922-1557				PPO - BBA		C	Philadelphia
H3916	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	1-717-302-2748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 890407	Camp Hill	PA	17089-0407	02/01/2018	2023	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H3917	Automated TrOOP Balance Transfer Contact			PATNAIK	PADDY		1-952-983-4787					ESITroopTransfer@express-scripts.com	PITTSBURGH CARE PARTNERSHIP, INC	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/05/2009	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Best Available Evidence Contact	FINANCE DIRECTOR	MRS	TRUMP	ANGIE	M	1-412-436-1333				1-412-235-1344	trumpam@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	11/18/2010	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Chief Financial Officer	FINANCE DIRECTOR	MRS	TRUMP	ANGIE	M	1-412-436-1333				1-412-235-1344	trumpam@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	05/22/2020	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	CMS Casework Communication Contact	FINANCE DIRECTOR	MRS	Trump	Angie	M	1-412-436-1333				1-412-235-1344	trumpam@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	08/03/2021	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Coordination of Benefits Contact	FINANCE DIRECTOR	MRS	Trump	Angie	M	1-412-436-1333				1-412-235-1344	trumpam@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	08/03/2021	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Customer Service Operations Contact	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		1-412-436-1344				1-412-235-1348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Government Relations Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		1-412-436-1341				1-412-235-1341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Medicare Compliance Officer	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		1-412-436-1344				1-412-235-1348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Part D Exceptions Contact	FINANCE DIRECTOR	MRS	Trump	Angie	M					1-412-235-1344	trumpam@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	08/03/2021	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active	1-412-436-1333				PACE - Nat		C	Philadelphia
H3917	Pharmacy Network Management Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		1-412-436-1341				1-412-235-1341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Pharmacy Technical Help Desk Contact	Finance Director		Trump	Angie						1-412-235-1341	trumpam@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	08/03/2021	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active	1-412-436-1333				PACE - Nat		C	Philadelphia
H3917	Plan to Plan Reconciliation Contact	Accounting Manager		PAVLIC	RENEE		1-412-436-1327				1-412-235-1344	pavlicrl2@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	03/03/2021	2023	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Automated TrOOP Balance Transfer Contact	CFO	Ms.	Schmitt	Laura	B	1-412-388-8042				1-412-388-8055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Best Available Evidence Contact	CFO	Ms.	Schmitt	Laura	B	1-412-388-8042				1-412-388-8055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Chief Financial Officer	CFO	Ms.	Schmitt	Laura	B	1-412-388-8042				1-412-388-8055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	CMS Casework Communication Contact	CFO	Ms.	Schmitt	Laura	B	1-412-388-8042				1-412-388-8055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Coordination of Benefits Contact	CFO	Ms.	Schmitt	Laura	B	1-412-388-8042				1-412-388-8055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Customer Service Operations Contact	CEO	Ms.	Gago	Joann	F	1-412-388-8042				1-412-388-8055	jgago@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	12/13/2016	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Government Relations Contact	CEO	Ms.	Gago	Joann	F	1-412-388-8042				1-412-388-8055	jgago@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	12/13/2016	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Medicare Compliance Officer	CFO	Ms.	Schmitt	Laura	B	1-412-388-8042				1-412-388-8055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Exceptions Contact	CFO	Ms.	Schmitt	Laura	B					1-412-388-8055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active	1-412-388-8042				PACE - Nat		C	Philadelphia
H3918	Pharmacy Network Management Contact	CEO	Ms.	Gago	Joann	F	1-412-388-8042				1-412-388-8055	jgago@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	12/13/2016	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Pharmacy Technical Help Desk Contact	Medical Director		Guilinger	Ruth	A					1-412-388-8055	Rguilinger@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	11/16/2022	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active	1-412-388-8055				PACE - Nat		C	Philadelphia
H3918	Plan to Plan Reconciliation Contact	CFO	Ms.	Schmitt	Laura	B	1-412-388-8042				1-412-388-8055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2023	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly	142	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Automated TrOOP Balance Transfer Contact	Regional Finance Director	Mr	Schmotzer	David		1-215-339-4533				1-215-339-5650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Best Available Evidence Contact	Regional Finance Director	Mr	Schmotzer	David		1-215-339-4533				1-215-339-5650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Chief Financial Officer	Regional Finance Director	Mr.	Schmotzer	David		1-215-339-4533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/13/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	CMS Casework Communication Contact	Manager Part D Compliance		Garbarino	Joseph		1-215-339-4362					Joseph.Garbarino@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	09/03/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Coordination of Benefits Contact	Regional Finance Director	Mr	Schmotzer	David		1-215-339-4533				1-215-339-5650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Customer Service Operations Contact	Regional VP Operations	Ms	Januszeski	Suzanne		1-856-904-4632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/25/2022	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Government Relations Contact	Director of Quality & Compliance	Mrs.	Hampton	Kimberly		1-215-339-4449				1-610-271-9530	kimberly.hampton@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	09/24/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/01/2020	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Part D Exceptions Contact	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 S. Broad Street		Philadelphia	PA	19145	08/13/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Philadelphia
H3919	Pharmacy Network Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		1-215-339-4362					joseph.garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	09/03/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Pharmacy Technical Help Desk Contact	Client Support Specialist	Ms.	Mazur	Lolita							landerson@pharmastarpbm.com	Pharmastar PBM	2503 N. Hillcrest Parkway	Altoona	WI	54720	08/13/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	1-888-298-7770				PACE - Nat		C	Philadelphia
H3919	Plan to Plan Reconciliation Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		1-215-339-4362				1-215-339-5650	Joseph.Garbarino@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	09/03/2021	2023	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3923	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Best Available Evidence Contact	Manager, Medicare Enrollment, Billing & Recon	Ms.	Peterson	Nicole		1-717-541-6419				1-717-346-5811	nicole.peterson@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/08/2021	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Chief Financial Officer	Chief Financial Officer	Mr.	Woodard	Ralph		1-717-541-7181					ralph.woodard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/24/2021	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	CMS Casework Communication Contact		Ms.	Drawbaugh	Cindy		1-717-541-6257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/16/2022	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Coordination of Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Customer Service Operations Contact	Director Medicare Operations	Mr.	Koch	Jonathan		1-717-829-2114				1-717-651-8873	jonathan.koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	06/17/2020	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Government Relations Contact	Sr. VP & General Counsel	Mr.	Hopkins	Joel		1-717-541-6358				1-717-651-4445	Joel.Hopkins@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	07/19/2021	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Hospice Contact	Sr. Director Pharmacy and Clinical Svcs	Ms.	Leedock	Melissa		1-717-541-6934				1-717-651-4850	Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Yu	Gloria		1-717-541-7278					Gloria.Yu@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/09/2022	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Part D Exceptions Contact	Senior Director, Medicare Pharmacy Operations	Ms	Leedock	Melissa							Melissa.Leedock@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	01/02/2020	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active	1-866-987-4213				PPO - BBA		C	Philadelphia
H3923	Pharmacy Network Management Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3923	Pharmacy Technical Help Desk Contact	Director, Member Services	Ms	Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics LLC 2655 Eagan Woods Drive		Eagan	MN	55122	09/08/2021	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active	1-888-878-0151				PPO - BBA		C	Philadelphia
H3923	Plan to Plan Reconciliation Contact	Accountant I	Ms.	Beauduy	Tamara		1-717-541-6946					FinanceP2P-CASH@CapBlueCross.com	2500 Elmerton Avenue	Mail Drop 3237	Harrisburg	PA	17177	08/16/2021	2023	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Automated TrOOP Balance Transfer Contact	Manager, Government Programs	Mr.	Merkel	Patrick		1-570-214-4692				1-570-214-1367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Best Available Evidence Contact	Director, Health Plan Operations - Enrollment	Ms.	Kinney	Noelle	C	1-570-214-9270					nckinney@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	10/25/2021	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Chief Financial Officer	COO/CFO	Mr.	McCullough	Mark	A	1-570-214-0783					mmccullough1@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	12/28/2020	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	CMS Casework Communication Contact	Customer Service Team Coordinator		Peters	Joanne		1-570-214-3285				1-570-271-5970	jpeters@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	12/31/2015	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Coordination of Benefits Contact	Supervisor, Health Plan COB	Ms.	Minium, CPC	Joanne		1-570-849-7572					COB@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3251	04/20/2022	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Customer Service Operations Contact	Director, Health Plan Operations, Customer Care	Mr.	Sanders	John	R	1-570-214-8046					jrsanders@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	10/31/2019	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Government Relations Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	1-570-214-2193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3220	06/24/2022	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Hospice Contact	Claims and Benefits Auditor, GHP Pharmacy	Ms.	Seabrook	Naiki	A	1-570-214-7851				1-570-300-2122	naseabrook@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3245	11/01/2019	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Masser	Philip	J	1-570-214-9281				1-570-214-5305	pjmasser@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3220	09/22/2015	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Part D Exceptions Contact	Director, Pharmacy Services	Dr.	Miller	Jamie						1-570-214-6768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3245	12/22/2017	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active	1-800-988-4861				PPO - BBA		C	Philadelphia
H3924	Pharmacy Network Management Contact	PerformRx Director, Service Operations	Ms.	Leal MBA CHIE	Avelina		1-215-863-6540					aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/28/2020	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3924	Pharmacy Technical Help Desk Contact	PerformRx Director, Service Operations	Ms	Leal MBA CHIE	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/21/2021	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active	1-855-508-1715				PPO - BBA		C	Philadelphia
H3924	Plan to Plan Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		1-570-214-4692				1-570-214-1367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2023	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H3925	Automated TrOOP Balance Transfer Contact	NA	Mr.	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Best Available Evidence Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Chief Financial Officer	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	CMS Casework Communication Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Coordination of Benefits Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Customer Service Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Government Relations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Medicare Compliance Officer	Executive Director	Mr	Voeghtly	Robert		1-814-535-6000	22110			1-814-248-7902	RVoeghtly@seniorlifejohnstown.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Part D Exceptions Contact	Chief Financial Officer	Mr	Dodson	David						1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active	1-814-535-6000	22102			PACE - Nat		C	Philadelphia
H3925	Pharmacy Network Management Contact			Rowland	Bob		1-724-275-1203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Pharmacy Technical Help Desk Contact			Rowland	Bob							Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active	1-724-275-1203	219			PACE - Nat		C	Philadelphia
H3925	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3928	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-888-736-9118				1-888-554-7668	BAE/LISMailbox@aetna.com	Attn:  BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/03/2018	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3928	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3928	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3928	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3931	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3931	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3931	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3942	Automated TrOOP Balance Transfer Contact	Business Analyst		Chastain	Kelly		1-910-343-8209	145			1-910-343-8836	kelly.chastain@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/18/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Best Available Evidence Contact	Quality Assurance Coordinator	Ms.	Forney	Harriet		1-910-343-8209	155			1-910-343-8836	harriet.forney@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Chief Financial Officer	Controller	Ms.	Jones	Tammy		1-828-465-8007				1-910-343-8836	tjones@EveryAge.org	100 Leonard Ave		Newton	NC	28658	11/11/2022	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	CMS Casework Communication Contact	Executive Director	Ms	Finch	Ruth		1-910-343-8209	164			1-910-343-8836	ruth.finch@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Coordination of Benefits Contact	Business Analyst	Ms.	Chastain	Kelly		1-910-343-8209	145			1-910-343-8836	kelly.chastain@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Customer Service Operations Contact	Business Analyst	Ms.	Chastain	Kelly		1-910-343-8209	145			1-910-343-8836	kelly.chastain@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Government Relations Contact	Executive Director		Finch	Ruth		1-910-343-8209	164			1-910-343-8836	ruth.finch@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Medicare Compliance Officer	Quality Coordinator	Ms	Forney	Harriet		1-910-343-8209				1-910-343-8836	harriet.forney@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Exceptions Contact	Business Analyst		Chastain	Kelly						1-910-343-8836	kelly.chastain@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active	1-888-343-8209	161			PACE - Nat		C	Atlanta
H3942	Pharmacy Network Management Contact	Business Analyst		Chastain	Kelly		1-910-343-8209	145			1-910-343-8836	kelly.chastain@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Pharmacy Technical Help Desk Contact	Business Analyst	Ms.	Chastain	Kelly						1-910-343-8836	kelly.chastain@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active	1-888-343-8209	161			PACE - Nat		C	Atlanta
H3942	Plan to Plan Reconciliation Contact	Business Analyst	Ms.	Chastain	Kelly		1-910-343-8209	145			1-910-343-8836	kelly.chastain@elderhaus.com	1380 North College Road		Wilmington	NC	28405	11/19/2021	2023	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3949	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/20/2020	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H3949	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H3949	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3952	Automated TrOOP Balance Transfer Contact	Pharmacy Services Manager		Parisi	Dana		1-215-241-3265				1-215-241-3526	Dana.Parisi@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	02/26/2015	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Best Available Evidence Contact	Sr. Business Analyst		Caldwell	Geraldine		1-267-675-1809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Chief Financial Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		1-215-241-4614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	CMS Casework Communication Contact	Manager, Medicare Operations		Zonies	Melissa		1-267-675-1633					Melissa.Zonies@ibx.com	1901 Market Street, 11th Floor		Philadelphia	PA	19103	10/18/2016	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Coordination of Benefits Contact	Manager, COB/OPL		Hawkins	Veronica		1-215-640-7507	27507				Veronica.Hawkins@ibx.com	1901 Market Street	17th Floor	Philadelphia	PA	19103	12/24/2020	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Customer Service Operations Contact	Director, Contact Center		Lentz	Michael		1-215-793-3262	63262				michael.lentz@ibx.com	1900 Market Street	5th Floor	Philadelphia	PA	19103	11/01/2022	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Government Relations Contact	Director of Regulatory Performance Management		Wyka	Tara		1-215-241-3648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Hospice Contact	Manager Pharmacy Compliance		Wells	Erika		1-215-241-3596					Erika.Wells@ibx.com	1901 Market St.	29th Floor	Philadelphia	PA	19103	11/29/2021	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Medicare Compliance Officer	Dir, Corp. Compl, Privacy & Medicare Compl Officer	Mr.	Goldberg	Mitchell		1-215-241-9516				1-215-567-4542	mitchell.goldberg@ibx.com	1901 Market Street		Philadelphia	PA	19103	02/28/2020	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Part D Exceptions Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						1-215-241-2654	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-888-678-7015				HMO - Health Maintenance Organization		C	Philadelphia
H3952	Pharmacy Network Management Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		1-215-241-2654				1-215-241-3526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3952	Pharmacy Technical Help Desk Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						1-215-241-3526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-888-678-7015				HMO - Health Maintenance Organization		C	Philadelphia
H3952	Plan to Plan Reconciliation Contact	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		1-215-640-7265				1-215-241-2408	geoffrey.wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	02/18/2022	2023	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Automated TrOOP Balance Transfer Contact	Manager, Government Programs	Mr.	Merkel	Patrick		1-570-214-4692				1-570-214-1367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Best Available Evidence Contact	Director, Health Plan Operations - Enrollment	Ms.	Kinney	Noelle	C	1-570-214-9270					nckinney@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	10/25/2021	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Chief Financial Officer	COO / CFO	Mr.	McCullough	Mark	A	1-570-214-0783					mmccullough1@thehealthplan.com	100 North Academy Avenue		Danville	PA	17822	11/18/2020	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	CMS Casework Communication Contact	Customer Service Team Coordinator		Peters	Joanne		1-570-214-3285				1-570-271-5970	jpeters@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	12/31/2015	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Coordination of Benefits Contact	Supervisor, Health Plan COB	Ms.	Minium, CPC	Joanne		1-570-849-7572					COB@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3251	04/20/2022	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Customer Service Operations Contact	Director, Health Plan Operations, Customer Care	Mr.	Sanders	John	R	1-570-214-8046					jrsanders@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	11/01/2019	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Government Relations Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	1-570-214-2193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3220	06/24/2022	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Hospice Contact	Claims and Benefits Auditor, GHP Pharmacy	Ms.	Seabrook	Naiki	A	1-570-214-7851				1-570-300-2122	naseabrook@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3245	11/01/2019	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Masser	Philip	J	1-570-214-9281				1-570-214-5305	pjmasser@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3220	09/22/2015	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Part D Exceptions Contact	Director, Pharmacy Services	Dr.	Miller	Jamie						1-570-214-6768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3245	12/22/2017	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active	1-800-988-4861				HMO - Health Maintenance Organization		C	Philadelphia
H3954	Pharmacy Network Management Contact	PerformRx Director, Service Operations	Ms.	Leal MBA CHIE	Avelina		1-215-863-6540					aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/28/2020	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3954	Pharmacy Technical Help Desk Contact	PerformRx Director, Service Operations	Ms	Leal MBA CHIE	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/21/2021	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active	1-855-508-1715				HMO - Health Maintenance Organization		C	Philadelphia
H3954	Plan to Plan Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		1-570-214-4692				1-570-214-1367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2023	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Geisinger Health	96	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Automated TrOOP Balance Transfer Contact	Manager, Enrollment & Billing	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/05/2017	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Chief Financial Officer	CFO Highmark Health Plan	Mr.	Veach	Daryl		1-412-544-7531					Daryl.Veach@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/14/2021	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	1-412-544-4579				1-717-635-4209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/06/2020	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		1-412-544-4417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	12/26/2019	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		1-814-871-6712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/09/2020	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Government Relations Contact	SVP, Government Affiars	Mr.	Warfel	Michael	G	1-717-302-3979					michael.warfel@highmark.com	1800 Center St.		Camp Hill	PA	17011	03/18/2022	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Hospice Contact	Intake Coordinator		Welker	Jessica		1-717-888-3043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	10/25/2019	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		1-412-544-7031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/05/2017	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite P4207	Pittsburgh	PA	15222	11/14/2013	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active	1-800-600-2227				HMO - Health Maintenance Organization		C	Philadelphia
H3957	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3957	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/08/2022	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Philadelphia
H3957	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	1-717-302-2748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 890407	Camp Hill	PA	17089-0407	02/01/2018	2023	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Inc.	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-888-736-9118				1-888-554-7668	BAE/LISMailbox@aetna.com	Attn:  BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/03/2018	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H3959	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3959	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H3959	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Best Available Evidence Contact	Manager, Medicare Enrollment, Billing & Recon	Ms.	Peterson	Nicole		1-717-541-6419				1-717-346-5811	nicole.peterson@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/08/2021	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Chief Financial Officer	Chief Financial Officer	Mr.	Woodard	Ralph		1-717-541-7181					ralph.woodard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/24/2021	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	CMS Casework Communication Contact		Ms.	Drawbaugh	Cindy		1-717-541-6257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/16/2022	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Coordination of Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Customer Service Operations Contact	Director Medicare Operations	Mr.	Koch	Jonathan		1-717-829-2114				1-717-651-8873	jonathan.koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	06/17/2020	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Government Relations Contact	Sr. VP & General Counsel	Mr.	Hopkins	Joel		1-717-541-6358				1-717-651-4445	Joel.Hopkins@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	07/19/2021	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Hospice Contact	Sr. Director Pharmacy and Clinical Svcs	Ms.	Leedock	Melissa		1-717-541-6934				1-717-651-4850	Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Yu	Gloria		1-717-541-7278					Gloria.Yu@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/09/2022	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Part D Exceptions Contact	Senior Director, Medicare Pharmacy Operations	Ms	Leedock	Melissa							Melissa.Leedock@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	11/25/2020	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active	1-866-987-4213				HMO - Health Maintenance Organization		C	Philadelphia
H3962	Pharmacy Network Management Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3962	Pharmacy Technical Help Desk Contact	Director, Member Services	Ms	Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics LLC 2655 Eagan Woods Drive		Eagan	MN	55122	09/08/2021	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active	1-888-878-0151				HMO - Health Maintenance Organization		C	Philadelphia
H3962	Plan to Plan Reconciliation Contact	Accountant I	Ms.	Beauduy	Tamara		1-717-541-6946					FinanceP2P-CASH@CapBlueCross.com	2500 Elmerton Avenue	Mail Drop 3237	Harrisburg	PA	17177	08/16/2021	2023	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H3975	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H3975	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3975	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H3975	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H3977	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	Best Available Evidence Contact	Director of PACE Finance	Mr.	Ewing	Mark		1-303-869-4664				1-303-996-1600	mewing@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	Chief Financial Officer	CFO	Mrs.	Gutierrez	Barbara		1-303-869-4664				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	CMS Casework Communication Contact	Corporate Compliance Officer	Mrs.	Erwin	Dana		1-303-869-4664				1-303-996-1600	derwin@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-303-869-4664				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	Customer Service Operations Contact	Director of Quality	Ms.	Curry	Jill		1-303-869-4664				1-303-996-1600	jcurry@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/10/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	Government Relations Contact	Vice President Regulatory Affairs	Mrs.	Dahan	Beverley		1-303-869-4664				1-303-996-1600	bdahan@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	Medicare Compliance Officer	VP of Pharmacy Services	Mrs.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	Part D Exceptions Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending	1-720-974-6785				PACE - Nat		C	Atlanta
H3977	Pharmacy Network Management Contact	VP of Pharmacy Services	Mrs.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3977	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending	1-720-974-6785				PACE - Nat		C	Atlanta
H3977	Plan to Plan Reconciliation Contact	Medicare Compliance Manager		Brown	Lauren		1-303-869-4664				1-720-917-3390	lbrown2@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	08/17/2020	2023	INNOVAGE KENTUCKY PACE, LLC	National PACE	InnovAge Kentucky PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3979	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	1001 E. Lookout Drive	Chicago	IL	60601	03/11/2021	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Denver
H3979	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3979	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				HMO - Health Maintenance Organization		C	Denver
H3979	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3991	Automated TrOOP Balance Transfer Contact	VP Quality Finance	Ms	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street	Ste 201	Erie	PA	16507	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Best Available Evidence Contact	Director of Quality Improvement	Ms.	Sheeder	Shelby		1-814-592-7615					ssheeder@lifenwpa.org	103 N. Front Street, Suite 1	Suite 1	Clearfield	PA	16830	01/04/2023	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Chief Financial Officer	CFO	Mr.	Phillips	Jeffery		1-814-456-5433					jphillips@lifenwpa.org	100 State Street	Ste 201	Erie	PA	16507	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	CMS Casework Communication Contact	CEO	Mr	Fish	Richard		1-814-456-5433					rfish@lifenwpa.org	100 State Street	Ste 201	Erie	PA	16507	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Coordination of Benefits Contact	VP Quality Finance	Ms	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street	Ste 201	Erie	PA	16507	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Customer Service Operations Contact	Day Center Manager	Mr.	Loren	Bernie		1-313-597-2330					bernie.loren@cherryblossompace.com	1901 N Beauregard St	Ste 110	Alexandria	VA	22311	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Government Relations Contact	CEO	Mr	Fish	Richard		1-814-456-5433					rfish@lifenwpa.org	100 State Street	Ste 201	Erie	PA	16507	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Medicare Compliance Officer	Director Quality & Compliance	Ms.	Brooks	Shalema		1-667-201-8014					shalema.brooks@cherryblossompace.com	1901 NorthBeauregard street	Ste 110	Alexandria	VA	22311	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part D Exceptions Contact	VP Contracts -Part D	Mr.	Feldmann	William							HPMS-MedD@lifenwpa.org	100 State Street	Ste 201	Erie	PA	16507	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	1-814-456-5433				PACE - Nat		C	Philadelphia
H3991	Pharmacy Network Management Contact	Executive Director	Ms	Cunningham	Kate		1-571-789-0770					kate.cunningham@cherryblossompace.com	1901 N Beauregard St	Ste 110	Alexandria	VA	22311	08/18/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Schoenburg	Racheli							racheli.schoenburg@cherryblossompace.com	1901 N Beauregard St	Ste 110	Alexandria	VA	22311	11/17/2021	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	1-571-789-0770				PACE - Nat		C	Philadelphia
H3991	Plan to Plan Reconciliation Contact	VP Quality Finance	Ms	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street	Ste 201	Erie	PA	16507	11/14/2022	2023	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4003	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Best Available Evidence Contact	AVP Enrollment and Membership Accounting	Ms.	Suarez	Yamile		1-787-622-3000	1745			1-787-999-2199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918-2137	12/09/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Chief Financial Officer	Chief Financial Officer	Mr.	Vivaldi	Carlos		1-787-622-3000	2295			1-787-622-0471	Carlos.Vivaldi@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/08/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	CMS Casework Communication Contact	Compliance Operations AVP	Ms.	Hiraldo	Marieva		1-787-622-3000	2259			1-787-622-0471	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/09/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Coordination of Benefits Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Customer Service Operations Contact	Vice President of Operations	Mr.	Cruz	Christian		1-787-908-0779					christian.cruz@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00936	12/09/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Government Relations Contact	Corporate Compliance Officer	Ms.	Plumey	Myra		1-787-379-3327				1-787-622-0471	myra.plumey@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/09/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Hospice Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Medicare Compliance Officer	Corporate Compliance Officer	Ms.	Plumey	Myra		1-787-379-3327				1-787-622-0471	myra.plumey@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/09/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Exceptions Contact	Pharmacy Operation Director	Ms	Rivera	Erika						1-787-300-5503	erika.rivera@mmmhc.com	PO BOX 71114		San Juan	PR	00936-8014	10/25/2019	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-866-333-5470	8633			HMO - Health Maintenance Organization		C	Chicago
H4003	Pharmacy Network Management Contact	Pharmacy Services Manager	Ms	Rodriguez	Isis		1-787-653-2814				1-787-286-6032	irodriguezp@mc-21.com	MC-21 Corporation	Call Box 4908	Caguas	PR	00726	11/11/2016	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Pharmacy Technical Help Desk Contact	PharmacyAVP		Caratini	Fernando						1-787-300-5503	Fernando.Caratini-Gregorio@mmmhc.com	PO BOX 71114		San Juan	PR	00936-8014	11/10/2016	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-877-776-7706				HMO - Health Maintenance Organization		C	Chicago
H4003	Plan to Plan Reconciliation Contact	Revenue and Med Cost Accounting Supervisor	Mr.	Serrano Figueroa	Juan		1-787-622-3000	2112				Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	08/17/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Best Available Evidence Contact	AVP Enrollment and Membership Accounting	Ms.	Suarez	Yamile		1-787-622-3000	1745			1-787-999-2199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918-2137	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Chief Financial Officer	Chief Financial Officer	Mr.	Vivaldi	Carlos		1-787-622-3000	2295			1-787-622-0471	Carlos.Vivaldi@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	CMS Casework Communication Contact	Compliance Operations AVP	Ms.	Hiraldo	Marieva		1-787-622-3000	2259			1-787-622-0471	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Coordination of Benefits Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Customer Service Operations Contact	Vice President of Operations	Mr.	Cruz	Christian		1-787-908-0779					christian.cruz@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00936	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Government Relations Contact	Corporate Compliance Officer	Ms.	Plumey	Myra		1-787-379-3327				1-787-622-0471	myra.plumey@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Hospice Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Medicare Compliance Officer	Corporate Compliance Officer	Ms.	Plumey	Myra		1-787-379-3327				1-787-622-0471	myra.plumey@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Exceptions Contact	Pharmacy Operation Director	Ms	Rivera	Erika						1-787-300-5503	erika.rivera@mmmhc.com	PO BOX 71114		San Juan	PR	00936-8014	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-866-333-5470	8633			HMO - Health Maintenance Organization		C	Chicago
H4004	Pharmacy Network Management Contact	Pharmacy Services Manager	Ms	Rodriguez	Isis		1-787-653-2814				1-787-286-6032	irodriguezp@mc-21.com	MC-21 Corporation	Call Box 4908	Caguas	PR	00726	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Pharmacy Technical Help Desk Contact	PharmacyAVP		Caratini	Fernando						1-787-300-5503	Fernando.Caratini-Gregorio@mmmhc.com	PO BOX 71114		San Juan	PR	00936-8014	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-877-776-7706				HMO - Health Maintenance Organization		C	Chicago
H4004	Plan to Plan Reconciliation Contact	Revenue and Med Cost Accounting Supervisor	Mr.	Serrano Figueroa	Juan		1-787-622-3000	2112				Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	PMC Medicare Choice	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4005	Automated TrOOP Balance Transfer Contact	MA Revenue Management Director	Mr	Rosich	Luis		1-787-975-1365	8321176			1-787-993-3257	lrosich@sssadvantage.com	PO Box 11320		San Juan	PR	00922	11/01/2019	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Best Available Evidence Contact	MA Enrollment & Reconciliation Director		Toste	Maria		1-787-749-4949	8322541			1-787-522-4307	mtoste@sssadvantage.com	PO Box 11320		San Juan	PR	00922	06/09/2020	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Chief Financial Officer	CFO & EVP	Mr.	Haddock	Victor	J	1-787-749-4949	8322430			1-787-706-4041	victor.haddock@ssspr.com	P.O. Box 363628		San Juan	PR	00936-3628	05/17/2021	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	CMS Casework Communication Contact	Appeals and Grievances Manager	Mrs	Martinez	Aixa		1-787-749-4949	8322307			1-787-993-3261	aixam@sssadvantage.com	PO Box 11320		San Juan	PR	00922	08/12/2020	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Coordination of Benefits Contact	MA Enrollment & Reconcilliation Director	Mrs.	Toste	Maria		1-787-749-4949	8322541			1-787-522-4307	mtoste@sssadvantage.com	PO Box 11320		San Juan	PR	00922	04/26/2022	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Customer Service Operations Contact	Customer Service Manager	Mr.	Jaxon	Harold		1-787-664-9288				1-787-620-0931	harold.jaxon@ssspr.com	PO Box 363628		San Juan	PR	00922	12/21/2022	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Government Relations Contact	Compliance Officer & VP	Ms	Cardenas	Jenny		1-787-749-4949	8322438			1-787-993-3260	jennycar@sssadvantage.com	PO Box 11320		San Juan	PR	00922	03/09/2020	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Hospice Contact	Medical Director	Mrs.	Rivas	Jadeyra		1-787-749-4949	8322358			1-787-522-4004	jadeyra.rivas@ssspr.com	PO Box 11320		San Juan	PR	00922	03/21/2022	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Medicare Compliance Officer	Compliance Officer & VP	Mrs	Cardenas	Jenny	D	1-787-749-4949	8322438			1-787-993-3260	jennycar@sssadvantage.com	PO Box 11320		San Juan	PR	00922-9905	03/09/2020	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Part D Exceptions Contact	Pharmacy Senior Manager	Mrs	Graxirena	Dalia						1-787-522-4004	dgraxire@sssadvantage.com	PO Box 11320		San Juan	PR	00922	03/21/2022	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	1-787-749-4949	8321812			PPO - BBA		C	New York
H4005	Pharmacy Network Management Contact	Director of Service Operations		Hernandez	Hector		1-787-523-1212	1123				hector.hernandez@abarcahealth.com	650 Avenida Muñoz Rivera	Suite 701	San Juan	PR	00918	01/04/2021	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4005	Pharmacy Technical Help Desk Contact	Director of Service Operations		Hernandez	Hector						1-787-523-1240	hector.hernandez@abarcahealth.com	650 Avenida Muñoz Rivera	Suite 701	San Juan	PR	00918	01/04/2021	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	1-855-922-2722				PPO - BBA		C	New York
H4005	Plan to Plan Reconciliation Contact	MA Revenue Management Director	Ms	Rosich	Luis		1-787-975-1365	8321176			1-787-993-3257	lrosich@sssadvantage.com	PO Box 11320		San Juan	PR	00922	11/01/2019	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	New York
H4007	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H4007	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4007	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H4007	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4036	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H4036	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4036	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H4036	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4045	Automated TrOOP Balance Transfer Contact	Director, Pharmacy and Utilization Management	Dr.	Huynh	Dang		1-408-874-1901					dhuynh@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Best Available Evidence Contact	Manager, Medicare Oureach	Mr.	Ly	Thien		1-408-874-1941					tly@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Chief Financial Officer	Chief Financial Officer	Mr.	Jarecki	Neal		1-408-874-1892					NJarecki@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	CMS Casework Communication Contact	Manager, Grievance & Appeals	Mr.	Oliveira	Mauro		1-408-874-1966				1-408-874-1962	MOliveira@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Coordination of Benefits Contact			email	COB		1-408-874-1866					COB@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	04/20/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Customer Service Operations Contact	Director, Customer Services	Ms.	Nguyen	Tanya		1-408-874-1851					tnguyen@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Government Relations Contact	Director, Government Relations	Mr.	Haskell	Tyler		1-408-874-1749					thaskell@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Hospice Contact	Chief Medical Officer	Dr.	Nakahira	Laurie		1-408-874-1990					lnakahira@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Medicare Compliance Officer	Medicare Compliance Manager	Mr.	Quan	Daniel		1-408-532-3349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Part D Exceptions Contact	Director, Pharmacy and Utilization Management	Dr.	Huynh	Dang							Dhuynh@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active	1-408-874-1901				HMO - Health Maintenance Organization		C	San Francisco
H4045	Pharmacy Network Management Contact	Director, Pharmacy and Utilization Management	Dr.	Huynh	Dang		1-408-874-1901					dhuynh@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4045	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active	1-888-807-8666				HMO - Health Maintenance Organization		C	San Francisco
H4045	Plan to Plan Reconciliation Contact	Controller		Granieri	Barbara		1-408-402-1711					bgranieri@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2023	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4053	Automated TrOOP Balance Transfer Contact	Manager- PACE Health Plan Operations	Mrs	Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	03/24/2020	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Best Available Evidence Contact	Manager- PACE Health Plan Operations	Mrs	Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	03/24/2020	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Chief Financial Officer	Manager- PACE Health Plan Operations	Mrs	Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	03/24/2020	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	CMS Casework Communication Contact	Director of Operations	Ms.	Burnette	Alison		1-803-434-4421				1-803-434-3773	alison.burnette2@prismahealth.org	3555 Harden Street Ext	Suite 203	Columbia	SC	29203	03/03/2022	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Coordination of Benefits Contact	Manager- PACE Health Plan Operations	Mrs	Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	03/24/2020	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Customer Service Operations Contact	Director of Operations	Ms.	Burnette	Alison		1-803-434-4421				1-803-434-3773	alison.burnette2@prismahealth.org	3555 Harden Street Ext	Suite 203	Columbia	SC	29203	03/03/2022	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Government Relations Contact	Director of Operations	Ms.	Burnette	Alison		1-803-434-4421				1-803-434-3773	alison.burnette2@prismahealth.org	3555 Harden Street Ext	Suite 203	Columbia	SC	29203	03/03/2022	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Medicare Compliance Officer	Director-Corporate Compliance/Corporate Compliance	Mr.	Pietras	Scott		1-867-797-7712					scott.pietras@prismahealth.org	300 E. McBee Avenue	Suite 302	Greenville	SC	29601	03/14/2022	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Part D Exceptions Contact	Manager- PACE Health Plan Operations	Mrs	Siler	Sarah						1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	03/24/2020	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active	1-844-722-3236				PACE - Nat		C	Atlanta
H4053	Pharmacy Network Management Contact	Manager, Pharmacy	Mr.	Sanders	Chuck		1-864-522-1962				1-864-522-1955	chuck.sanders@prismahealth.org	32 Centennial Way		Greenville	SC	29605	04/08/2019	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Pharmacy Technical Help Desk Contact	Manager, Pharmacy	Mr.	Sanders	Chuck						1-864-522-1955	chuck.sanders@prismahealth.org	32 Centennial Way		Greenville	SC	29605	04/08/2019	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active	1-800-998-8995				PACE - Nat		C	Atlanta
H4053	Plan to Plan Reconciliation Contact	Manager- PACE Health Plan Operations	Mrs	Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	03/24/2020	2023	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4054	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Dr	Ford	James	E	1-443-275-9801					jford@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Best Available Evidence Contact	Director of Partner Development	Ms	Radice	Sue		1-410-991-3213				1-844-462-3091	sradice@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Chief Financial Officer	CFO	Mr	Persinger	Keith		1-410-456-3946					kpersinger@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	CMS Casework Communication Contact	Chief Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Coordination of Benefits Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Customer Service Operations Contact	Sr. Director of Operations	Mr.	Brain	Jay		1-240-367-2626					JBrain@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/29/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Government Relations Contact			Grindrod	Rick		1-410-424-0772					rgrindrod@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Hospice Contact	Account Manager	Ms.	Sousa	Ana		1-215-872-4933					asousa@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Medicare Compliance Officer	Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	11/10/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Part D Exceptions Contact	Associate Vice President	Ms	Lavignette	Amanda							alavignette@envsionrx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Philadelphia
H4054	Pharmacy Network Management Contact	Director Pharmacy Network Development & Operations	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4054	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-844-846-8007				HMO - Health Maintenance Organization		C	Philadelphia
H4054	Plan to Plan Reconciliation Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	02/04/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4073	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H4073	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H4073	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4074	Automated TrOOP Balance Transfer Contact			Keyser	Denise		1-251-287-8420					Denisek@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/13/2016	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Best Available Evidence Contact	Executive Director	Ms	Overton	Kathryn		1-251-287-8420				1-251-287-8478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Chief Financial Officer	Executive Director	Ms	Overton	Kathryn		1-251-287-8420				1-251-287-8478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	CMS Casework Communication Contact	Executive Director	Ms	Overton	Kathryn		1-251-287-8420				1-251-287-8478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Coordination of Benefits Contact	Executive Director	Ms	Overton	Kathryn		1-251-287-8420				1-251-287-8478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Customer Service Operations Contact	Executive Director	Ms	Overton	Kathryn		1-251-287-8420				1-251-287-8478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Government Relations Contact	Executive Director	Ms	Overton	Kathryn		1-251-287-8420				1-251-287-8478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/22/2020	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Part D Exceptions Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	01/04/2021	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Atlanta
H4074	Pharmacy Network Management Contact	Executive Director	Ms	Overton	Kathryn		1-251-287-8420				1-251-287-8478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Pharmacy Technical Help Desk Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	04/28/2022	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Atlanta
H4074	Plan to Plan Reconciliation Contact			Keyser	Denise		1-251-287-8420					Denisek@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/13/2016	2023	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4091	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Best Available Evidence Contact	Director, Operations		Brenier	Holly		1-205-757-9107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	01/02/2023	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Chief Financial Officer	CFO	Mrs.	Brenier	Holly		1-205-757-9107					Holly.Brenier@acvcorp.com	3008 Seventh Avenue South		Birmingham	AL	35233	10/03/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	CMS Casework Communication Contact	Chief Compliance Officer		Blair	Cassandra		1-205-739-4100					Cassandra.Blair@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	05/17/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Coordination of Benefits Contact	CFO/COO		Brenier	Holly		1-205-757-9107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	01/02/2023	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Customer Service Operations Contact	CFO/COO		Brenier	Holly		1-205-757-9107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	01/02/2023	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Government Relations Contact	Chief Compliance Officer		Blair	Cassandra		1-205-739-4100					Cassandra.Blair@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	12/05/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Hospice Contact	Director Pharmacy Operations		Jacobi	Jackie		1-205-757-9007					jackie.jacobi@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	12/05/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Blair	Cassandra		1-205-739-4100					Cassandra.Blair@ACVCorp.com	3008 Seventh Avenue South		Birmingham	AL	35233	07/05/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Part D Exceptions Contact	Sr. Manager, Clinical Prior Authorization		LeClair	Christophe						1-920-221-4676	Christopher.LeClair@Navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	03/23/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active	1-920-221-4176				PPO - BBA		C	Atlanta
H4091	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688					Jan.Robinson@navitus.com	361 Integrity Drive		Madison	WI	53717	12/12/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4091	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	03/23/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active	1-866-270-3877	4224			PPO - BBA		C	Atlanta
H4091	Plan to Plan Reconciliation Contact	CFO/COO		Brenier	Holly		1-205-757-9107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	12/05/2022	2023	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	Atlanta
H4093	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Dr	Ford	James	E	1-443-275-9801					jford@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Best Available Evidence Contact	Director of Partner Development	Ms	Radice	Sue		1-410-991-3213				1-844-462-3091	sradice@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Chief Financial Officer	CFO	Mr	Persinger	Keith		1-410-456-3946					kpersinger@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	12/29/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	CMS Casework Communication Contact	Chief Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/03/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Coordination of Benefits Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/30/2019	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Customer Service Operations Contact	Sr. Director of Operations	Mr.	Brain	Jay		1-240-367-2626					JBrain@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/29/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Government Relations Contact			Grindrod	Rick		1-410-424-0772					rgrindrod@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Hospice Contact	Account Manager	Ms.	Sousa	Ana		1-215-872-4933					asousa@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Medicare Compliance Officer	Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	11/10/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Part D Exceptions Contact	Associate Vice President	Ms	Lavignette	Amanda							alavignette@envsionrx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	11/10/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Philadelphia
H4093	Pharmacy Network Management Contact	Director Pharmacy Network Development & Operations	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4093	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-844-846-8007				HMO - Health Maintenance Organization		C	Philadelphia
H4093	Plan to Plan Reconciliation Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/30/2019	2023	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4094	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/25/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H4094	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4094	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H4094	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4105	Automated TrOOP Balance Transfer Contact	Health Plan Manager		Loiselle	Amanda		1-401-654-4071				1-401-654-4660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	Best Available Evidence Contact	CEO		Kwiatkowski	Joan	L	1-401-654-4564				1-401-654-4660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	Chief Financial Officer	CFO	Mr.	McAnaugh	Craig		1-401-654-4074				1-401-654-4660	cmcanaugh@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	05/25/2022	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	CMS Casework Communication Contact	CFO	Mr.	McAnaugh	Craig		1-401-654-4074				1-401-654-4660	cmcanaugh@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	05/25/2022	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	Coordination of Benefits Contact	Senior Accountant		Swierk	Doreen		1-401-768-3035				1-401-654-4660	dswierk@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	Customer Service Operations Contact	Chief Marketing & Development Officer	Mr.	Boucher	Tom		1-401-654-4644				1-401-654-4660	tboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	Government Relations Contact	CEO	Mrs.	Kwiatkowski	Joan	L	1-401-654-4564				1-401-654-4660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	Medicare Compliance Officer	Chief of Organizational Performance	Mrs.	Boucher	Liz		1-401-654-5255				1-401-654-4660	lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	Part D Exceptions Contact	Reporting and Compliance Specialist		Loiselle	Amanda						1-401-654-4660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active	1-877-781-7223				PACE - Nat		C	Boston
H4105	Pharmacy Network Management Contact	Pharmacist		Dyer	Curtis		1-401-654-5254					cdyer@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/25/2022	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4105	Pharmacy Technical Help Desk Contact	Pharmacist		Dyer	Curtis	L					1-401-654-4660	cdyer@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/25/2022	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active	1-401-654-5254				PACE - Nat		C	Boston
H4105	Plan to Plan Reconciliation Contact	Health Plan Manager		Loiselle	Amanda		1-401-654-4071				1-401-654-4660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2023	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active					PACE - Nat		C	Boston
H4118	Automated TrOOP Balance Transfer Contact	Director of Finance	Mrs	Dukes	Jaclyn		1-734-572-5777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	Best Available Evidence Contact	Executive Director	Mrs	Love-Felton	Sonja		1-734-572-5777					SFelton@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	11/09/2018	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	Chief Financial Officer	Director of Finance	Mrs	Dukes	Jaclyn		1-734-572-5777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	CMS Casework Communication Contact	Executive Director	MRS	Love-Felton	Sonja		1-734-572-5777					SFelton@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	03/27/2018	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	Coordination of Benefits Contact	Director of Finance	Mrs	Dukes	Jaclyn		1-734-572-5777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	Customer Service Operations Contact	Quality Director	Mrs	Gearhart	Felicia		1-734-879-0324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	Government Relations Contact	Executive Director	MRS	Love-Felton	Sonja		1-734-572-5777					SFelton@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	03/27/2018	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	Medicare Compliance Officer	Quality Director	Mrs	Gearhart	Felicia		1-734-879-0324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	02/11/2019	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	Part D Exceptions Contact	Director of Finance	Mrs	Dukes	Jaclyn							jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	06/27/2018	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active	1-855-483-7223				PACE - Nat		C	Chicago
H4118	Pharmacy Network Management Contact	Director of Finance	Mrs	Dukes	Jaclyn		1-734-572-5777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4118	Pharmacy Technical Help Desk Contact	Quality Director	Mrs	Gearhart	Felicia							fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active	1-855-483-7223				PACE - Nat		C	Chicago
H4118	Plan to Plan Reconciliation Contact	Director of Finance	Mrs	Dukes	Jaclyn		1-734-572-5777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2023	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Chicago
H4140	Automated TrOOP Balance Transfer Contact	Medicare Part D Program Manager		Rivera Aquino	Denisse		1-858-291-5269					partDCAT@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/07/2022	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Best Available Evidence Contact	Director of Enrollment		Hernandez	Gloria		1-786-578-0959				1-786-578-0964	ghernandez@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Chief Financial Officer	CFO	Ms.	Garrote Torra	Ivonne		1-786-578-0954				1-786-578-0282	i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/07/2021	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	CMS Casework Communication Contact	VP, Administration		Griffin	Susan		1-786-578-0947					jcurbelo@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Coordination of Benefits Contact	CFO		Garrote- Torra	Ivonne		1-786-578-0954				1-786-578-0289	i.gtor03@doctorshcp.com	2020 Ponce De Leon Bvd	PH 1	Coral Gables	FL	33134	07/22/2022	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Customer Service Operations Contact	Director Member Services		Curbelo	Jenny		1-786-578-0956				1-786-578-0283	jcurbelo@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Government Relations Contact	Compliance Officer		Campuzano	Mayra		1-786-584-8349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Hospice Contact	Chief Medical Officer	Dr.	Cabrera	Jorge		1-786-578-0962					j.cabr14@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	07/22/2022	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Medicare Compliance Officer	VP, Compliance Officer	Ms.	Campuzano	Mayra		1-786-584-8349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Part D Exceptions Contact	Director, Pharmacy		Perna	Lynette							lperna@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	11/29/2022	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active	1-786-584-8345				HMO - Health Maintenance Organization		C	Atlanta
H4140	Pharmacy Network Management Contact	Director, Pharmacy Network Administration		Hunt	Brian		1-858-790-7092					brian.hunt@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/07/2022	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4140	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/07/2022	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active	1-800-910-4730				HMO - Health Maintenance Organization		C	Atlanta
H4140	Plan to Plan Reconciliation Contact	CFO		Garrote Torra	Ivonne		1-786-578-0954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH1	Coral Gables	FL	33134	10/07/2021	2023	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4141	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H4141	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4141	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H4141	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4142	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Ms.	Pittman	Thelma		1-918-207-4936				1-918-207-0141	thelma-pittman@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	03/13/2019	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	Best Available Evidence Contact	QI/Compliance Manager	Ms.	Losing	Laura		1-918-207-4979				1-918-207-0141	laura-losing@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/10/2022	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	Chief Financial Officer	Chief Financial Officer	Ms.	Pittman	Thelma		1-918-207-4936				1-918-207-0141	thelma-pittman@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	03/13/2019	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	CMS Casework Communication Contact	QI/Compliance Manager	Ms.	Losing	Laura		1-918-207-4970				1-918-207-0141	laura-losing@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/10/2022	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	Coordination of Benefits Contact	Chief Financial Officer	Ms.	Pittman	Thelma		1-918-207-4936				1-918-207-0141	thelma-pittman@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	03/13/2019	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	Customer Service Operations Contact	QI/Compliance Manager	Ms.	Losing	Laura		1-918-207-4970				1-918-207-0141	laura-losing@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/10/2022	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	Government Relations Contact	Interim Program Director	Mrs	Davis	Connie		1-918-453-5554	5599			1-918-207-0141	connie-davis@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	03/13/2019	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	Medicare Compliance Officer	QI/Compliance Manager	Ms.	Losing	Laura		1-918-207-4970				1-918-207-0141	laura-losing@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/10/2022	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	Part D Exceptions Contact	Medical Director	Dr.	Galdamez	John						1-918-431-4112	john-galdamez@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	09/19/2014	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active	1-800-256-0671	5554			PACE - Nat		C	Dallas
H4142	Pharmacy Network Management Contact	Chief Financial Officer	Ms.	Pittman	Thelma		1-918-207-4936				1-918-207-0141	thelma-pittman@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	03/13/2019	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4142	Pharmacy Technical Help Desk Contact	Director of Technology Operations		Nyzio	Jason								CareKinesis, Inc.	110 Marter Avenue, Suite 309	Moorestown	NJ	08057	01/03/2014	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active	1-888-974-2763				PACE - Nat		C	Dallas
H4142	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Pittman	Thelma		1-918-207-4936				1-918-207-0141	thelma-pittman@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	03/13/2019	2023	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active					PACE - Nat		C	Dallas
H4152	Automated TrOOP Balance Transfer Contact	Director PBM Operations		Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/23/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Best Available Evidence Contact	Mng Dir Operations - Medicare Segment, Enrollment		Wisniewski	Ivona		1-401-459-1721				1-401-459-5649	ivona.wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	12/19/2017	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Chief Financial Officer	CFO	Mr.	Stewart	Mark		1-401-459-5886				1-401-459-1290	mark.stewart@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/19/2016	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	CMS Casework Communication Contact	Director, GAU		Antunes	Kathy		1-401-459-5136				1-401-459-5668	kathy.antunes@bcbsri.org	500 Exchange Street		Providence	RI	02903	09/23/2021	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Coordination of Benefits Contact	Director PBM Operations		Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/23/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Customer Service Operations Contact	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		1-401-459-1721				1-401-459-5089	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	12/19/2017	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Government Relations Contact	SVP Government Programs		Pitney	Christina		1-401-459-1103					christina.pitney@bcbsri.org	500 Exchange Street		Providence	RI	02903	04/25/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Hospice Contact	Associate Director, Senior Market Enrollment		Peixoto	Kayla		1-774-955-9918					kayla.peixoto@bcbsri.org	50 Jordan Street		East Providence	RI	02914	10/04/2021	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Pennypacker	Regan		1-401-743-0003				1-401-459-1598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	04/12/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Part D Exceptions Contact	Regulatory Director		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/23/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Boston
H4152	Pharmacy Network Management Contact	VP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	Marci.Conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/23/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4152	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/12/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active	1-855-457-1207				HMO - Health Maintenance Organization		C	Boston
H4152	Plan to Plan Reconciliation Contact	Sr. Health Data Analyst		Simas	Heather		1-401-459-5286				1-401-459-1198	heather.simas@bcbsri.org	PO Box 1057		Providence	RI	02901	12/13/2022	2023	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Local CCP	Blue Cross & Blue Shield of Rhode Island	HMO/HMOPOS		Blue Cross & Blue Shield of Rhode Island	24	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4161	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	01/10/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	01/10/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	01/10/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	01/10/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H4161	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-833-377-4266					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	12/08/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	01/03/2023	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H4161	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	01/10/2022	2023	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/01/2019	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	06/21/2022	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/01/2019	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Medicare Compliance Officer	Compliance Officer	Ms.	Maxwell	Jill		1-615-890-2020	1666				compliance@nhcadvantageplan.com	100 East Vine Street		Murfreesboro	TN	37130	04/22/2021	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/15/2021	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Kansas City
H4172	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/15/2021	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4172	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Kansas City
H4172	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4185	Automated TrOOP Balance Transfer Contact	Controller		Irving	Jennifer		1-442-257-2190					jennifer.irving@nhcare.org	425 N Date St		Escondido	CA	92025	02/21/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Best Available Evidence Contact	Chief Medical Officer	Dr.	Schultz	James		1-442-286-8409					jims@nhcare.org	425 N Date St		Escondido	CA	92025	02/21/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Chief Financial Officer	Chief Financial Officer	Ms	Daigle	Lisa		1-442-286-8196					lisad@nhcare.org	425 N Date St		Escondido	CA	92025	02/21/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	CMS Casework Communication Contact	Senior Director of Marketing & Community Engagemen		Zavala	Adrian		1-951-263-7296					adrian.zavala@nhcare.org	4371 Latham Street		Riverside	CA	92501	02/21/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Coordination of Benefits Contact	Revenue Cycle Director		Garcia	Belinda		1-442-286-8985					belinda.garcia@nhcare.org	425 N Date St		Escondido	CA	92025	02/21/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Customer Service Operations Contact	Senior Director Marketing & Community Engagement		Zavala	Adrian		1-951-263-7296					Adrian.Zavala@nhcare.org	4371 Latham St.		Riverside	CA	92501	05/26/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Government Relations Contact	PACE Compliance Officer		Godisan	Healery		1-951-543-9038					healery.godisan@nhcare.org	4371 Latham St		Riverside	CA	92501	04/26/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Medicare Compliance Officer	PACE Compliance Officer	Ms	Godisan	Healery		1-951-543-9038					healery.godisan@nhcare.org	4371 Latham St		Riverside	CA	92501	04/26/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part D Exceptions Contact	Financial Analyst		Grant	Christa							christa.grant@nhcare.org	425 N Date St		Escondido	CA	92025	02/21/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active	1-442-257-2082				PACE - Nat		C	San Francisco
H4185	Pharmacy Network Management Contact	Financial Analyst		Grant	Christa		1-442-257-2082					christa.grant@nhcare.org	1540 E. Valley Parkway		Escondido	CA	92025	02/21/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Pharmacy Technical Help Desk Contact	Clinical Pharmacist		Hughes	Michelle							Michelle.Hughes@nhcare.org	1540 E. Valley Parkway		Escondido	CA	92025	02/24/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active	1-442-286-8542				PACE - Nat		C	San Francisco
H4185	Plan to Plan Reconciliation Contact	Revenue Cycle Director		Garcia	Belinda		1-442-286-8985					belinda.garcia@nhcare.org	1540 E. Valley Parkway		Escondido	CA	92025	02/24/2022	2023	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4198	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Services		Perez	Charles		1-918-594-5295	6479				cperez@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/06/2017	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Best Available Evidence Contact	Supervisor, Medicare Enrollment		East	Shawn		1-918-594-5295	6903				seast@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/06/2017	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Chief Financial Officer	SR VP & CFO	Mr.	Butcher	Jeffrey		1-918-594-5295	5308				jbutcher@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	08/16/2021	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	CMS Casework Communication Contact	Supervisor, Pharmacy Services		Burke	Amy		1-918-594-5295	6808			1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Coordination of Benefits Contact	Supervisor, Claims		Higgins	Susan		1-918-594-5295	6401				coordinationofbenefits@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	09/21/2022	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Customer Service Operations Contact	VP Operations		White	Sherrie		1-918-594-5295	5386				swhite@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Government Relations Contact	VP Chief Risk & Compliance Officer		Hill	Andrew		1-918-594-5295	4055				ahill@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	08/16/2021	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Hospice Contact	Supervisor, Pharmacy Services		Burke	Amy		1-918-594-5295	6808			1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Medicare Compliance Officer	VP Chief Risk & Compliance Officer	Mr.	Hill	Andrew		1-918-594-5295	4055				ahill@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	08/16/2021	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Part D Exceptions Contact	Supervisor, Pharmacy Services		Burke	Amy						1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	1-877-293-8628	6808			HMO - Health Maintenance Organization		C	Dallas
H4198	Pharmacy Network Management Contact	Manager, Pharmacy Services		Perez	Charles		1-918-594-5295	6479				cperez@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	04/24/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4198	Pharmacy Technical Help Desk Contact	Supervisor, Pharmacy Services		Burke	Amy						1-918-794-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	12/27/2018	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	1-877-293-8628	6808			HMO - Health Maintenance Organization		C	Dallas
H4198	Plan to Plan Reconciliation Contact	Senior Financial Analyst		Mack	Lynda		1-918-594-5295	6320				lmack@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	03/10/2020	2023	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	Integris Health Partners+ (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4203	Automated TrOOP Balance Transfer Contact	Manager-PACE Health Plan Operations		Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	02/10/2020	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Best Available Evidence Contact	Director	Ms.	Burnette	Alison		1-803-434-4421					alison.burnette2@prismahealth.org	15 Medical Park	Suite 203	Columbia	SC	29203	08/13/2021	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Chief Financial Officer	Manager-PACE Health Plan Operations	Mrs	Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	02/10/2020	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	CMS Casework Communication Contact	Director	Ms.	Burnette	Alison		1-803-434-4421					Alison.Burnette2@prismahealth.org	3555 Harden Street Ext	Suite 203	Columbia	SC	29203	08/13/2021	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Coordination of Benefits Contact	Manager-PACE Health Plan Operations		Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	02/10/2020	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Customer Service Operations Contact	Manager-PACE Health Plan Operations	Mrs	Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	01/11/2021	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Government Relations Contact	Director	Ms.	Burnette	Alison		1-803-434-4421				1-803-434-3773	Alison Burnette2@prismahealth.org	3555 Harden Street Ext	Suite 203	Columbia	SC	29203	08/13/2021	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Medicare Compliance Officer	Corporate Compliance Officer	Mr.	Pietras	Scott		1-864-797-7712					scott.pietras@prismahealth.org	300 E. McBee Ave	Suite 302	Greenville	SC	29601	08/13/2021	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Part D Exceptions Contact	Pharmacy Manager		Marsh	David							david.marsh@prismahealth.org	1308 Laurel Street		Columbia	SC	29203	11/26/2019	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active	1-803-931-8123				PACE - Nat		C	Atlanta
H4203	Pharmacy Network Management Contact	Pharmacy Manager		Marsh	David		1-803-931-8123					david.marsh@prismahealth.org	1308 Laurel Street		Columbia	SC	29203	11/26/2019	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Pharmacy Technical Help Desk Contact	Pharmacy Manager		Marsh	David							david.marsh@prismahealth.org	1308 Laurel Street		Columbia	SC	29203	11/26/2019	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active	1-803-931-8123				PACE - Nat		C	Atlanta
H4203	Plan to Plan Reconciliation Contact	Manager-PACE Health Plan Operations		Siler	Sarah		1-864-522-1966				1-864-522-1955	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	02/10/2020	2023	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4213	Automated TrOOP Balance Transfer Contact	Eligibility Supervisor		White	William		1-612-777-6736					eobp2p@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	11/06/2020	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Best Available Evidence Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Chief Financial Officer	CFO	Mr.	Winter	Scott		1-501-399-3951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	CMS Casework Communication Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Coordination of Benefits Contact	Eligibility Supervisor		White	William		1-612-777-6736					cobmedd@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	11/06/2020	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Customer Service Operations Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Government Relations Contact	Sr Counsel Gov''t Relation		Fenton	Janie		1-501-378-2103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		1-501-378-3743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Fenske	Anjenette		1-501-244-6350					amfenske@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/06/2020	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Part D Exceptions Contact			Review Audit & Regul	Clinical						1-800-693-6703	clinicalreviewclientinquiries@primetherapeutics.co	Centennial Crossings - Clinical Review 4401 West 76th S		Edina	MN	55435	11/06/2020	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active	1-800-693-6651				PFFS - Private Fee for Service		C	Dallas
H4213	Pharmacy Network Management Contact	Senior Director Network Provider Relations		Grindsteinner	Bretta		1-612-777-4021					bgrinsteinner@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	11/06/2020	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4213	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	Prime						1-888-285-2242	MGarzarodriguez@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	11/06/2020	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active	1-800-693-3815				PFFS - Private Fee for Service		C	Dallas
H4213	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		1-501-399-3958				1-501-378-3258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	04/26/2019	2023	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	Dallas
H4227	Automated TrOOP Balance Transfer Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		1-215-937-5325					nortiz@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	12/30/2020	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		1-484-497-1171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	12/26/2018	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Lopez	Juan		1-609-405-0539					Juan.Lopez@ibx.com	1901 Market Street, 39th floor		Philadelphia	PA	19103	11/04/2022	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	CMS Casework Communication Contact	Medicare QA Contract Acct Mgr	Ms.	Fine	Nicole		1-484-496-7479					nfine@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	10/17/2022	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Coordination of Benefits Contact	Manager, Provider Network Oversight	Ms.	Williams	Kathy		1-843-746-7499					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/09/2022	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		1-267-298-1794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	08/08/2022	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Government Relations Contact	Director, Public Policy	Mr.	Cozzo	Steven		1-215-937-8236					scozzo@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	100 Stevens Dr.	Philadelphia	PA	19113	10/14/2020	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Hospice Contact	Pharmacist II	Ms.	Shepard	Jen		1-215-937-8685					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	09/02/2021	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Solomon	Mary		1-267-300-4846					mlsolomon@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	09/02/2021	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						1-215-863-5100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	12/22/2016	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-215-863-6483				HMO - Health Maintenance Organization		C	Philadelphia
H4227	Pharmacy Network Management Contact	Director	Ms.	Leal	Avelina		1-215-863-6540					aleal@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	12/30/2020	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4227	Pharmacy Technical Help Desk Contact	Director, Service Operations	Ms.	Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2022	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-866-828-0023				HMO - Health Maintenance Organization		C	Philadelphia
H4227	Plan to Plan Reconciliation Contact	Director, Medicare Performance Management	Mr.	Kindred	Amanda		1-248-404-5991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4232	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/18/2020	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H4232	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4232	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-833-674-6196				HMO - Health Maintenance Organization		C	Dallas
H4232	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4235	Automated TrOOP Balance Transfer Contact	Director of Finance and Administration	CFO	Witt	Anne		1-704-874-0604				1-704-834-1998	awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	03/01/2022	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Best Available Evidence Contact	Executive Director		Kenzig	Cathy		1-704-874-0603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	01/26/2015	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Chief Financial Officer	Director of Finance and Administration	CFO	Witt	Anne		1-704-874-0604					awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	03/25/2019	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	CMS Casework Communication Contact	Executive Director		Kenzig	Cathy		1-704-874-0603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	12/29/2014	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Coordination of Benefits Contact	Finance Director		Witt	Anne		1-704-874-0604					awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	03/22/2018	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Customer Service Operations Contact	Executive Director		Kenzig	Cathy		1-704-874-0603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	12/29/2014	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Government Relations Contact	Executive Director		Kenzig	Cathy		1-704-874-0603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	12/29/2014	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Medicare Compliance Officer	Compliance & Quality Director	CIO	Alexander	Lydia		1-704-874-0639					lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	01/07/2021	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Part D Exceptions Contact	Executive Director		Kenzig	Cathy							ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	12/29/2014	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active	1-855-327-7852				PACE - Nat		C	Atlanta
H4235	Pharmacy Network Management Contact	Executive Director		Kenzig	Cathy		1-704-874-0603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	12/29/2014	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Pharmacy Technical Help Desk Contact	Executive Director		Kenzig	Cathy							ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	12/29/2014	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active	1-888-298-7770				PACE - Nat		C	Atlanta
H4235	Plan to Plan Reconciliation Contact	Executive Director		Kenzig	Cathy		1-704-874-0603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	01/26/2015	2023	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4256	Automated TrOOP Balance Transfer Contact	FinanceDirector	Mr.	Jacobs	John		1-231-252-3816				1-231-252-3750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	03/15/2021	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	Best Available Evidence Contact	Interim Executive Director	Ms	Farkas	Nicole		1-231-252-3801				1-231-252-3750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	10/18/2022	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	Chief Financial Officer	Financial Director	Mr	Jacobs	John		1-231-252-3816				1-231-252-3750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	CMS Casework Communication Contact	LMSW	Ms	Goble	Erica		1-231-252-3808				1-231-252-3750	egoble@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	03/15/2021	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	Coordination of Benefits Contact	Finance Director	Mr	Jacobs	John		1-231-252-3816				1-231-252-3750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	Customer Service Operations Contact	Executive Director	Ms	Farkas	Nicole		1-231-252-2767				1-231-252-3750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	12/20/2022	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	Government Relations Contact	Executive Director	Ms	Farkas	Nicole		1-231-252-3814				1-231-252-3750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	12/20/2022	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	Medicare Compliance Officer	Quality Director	Ms.	Reardon	Michelle		1-231-252-3821				1-231-252-3750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	09/30/2020	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	Part D Exceptions Contact	Finance Director	Mr	Jacobs	John						1-231-252-3750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active	1-231-252-3816				PACE - Nat		C	Chicago
H4256	Pharmacy Network Management Contact	Executive Director	Ms	JACOBS	John Jacob		1-231-252-3816				1-231-252-3750	jjacobs@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	12/20/2022	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4256	Pharmacy Technical Help Desk Contact	Executive Director	Ms	JACOBS	John Jacob						1-231-252-3750	jjacobs@pacenorth.org	2325 N Garfield Rd		Traverse City	MI	49686	12/20/2022	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active	1-231-252-3816				PACE - Nat		C	Chicago
H4256	Plan to Plan Reconciliation Contact	Finance Director	Mr	Jacobs	John		1-231-252-3816				1-231-252-3750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2023	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Chicago
H4277	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Services		Perez	Charles		1-918-594-5295	6479				cperez@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Best Available Evidence Contact	Supervisor, Medicare Enrollment		East	Shawn		1-918-594-5295	6903				seast@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Chief Financial Officer	SR VP & CFO	Mr.	Butcher	Jeffrey		1-918-594-5295	5308				jbutcher@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	CMS Casework Communication Contact	Supervisor, Pharmacy Services		Burke	Amy		1-918-594-5295	6808			1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Coordination of Benefits Contact	Supervisor, Claims		Higgins	Susan		1-918-594-5295	6401				coordinationofbenefits@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	09/21/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Customer Service Operations Contact	VP Operations		White	Sherrie		1-918-594-5295	5386				swhite@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Government Relations Contact	VP Chief Risk & Compliance Officer		Hill	Andrew		1-918-594-5295	4055				ahill@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Hospice Contact	Supervisor, Pharmacy Services		Burke	Amy		1-918-594-5295	6808			1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Medicare Compliance Officer	VP Chief Risk & Compliance Officer	Mr.	Hill	Andrew		1-918-594-5295	4055				ahill@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Part D Exceptions Contact	Supervisor, Pharmacy Services		Burke	Amy						1-918-879-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active	1-877-293-8628	6808			PPO - BBA		C	Dallas
H4277	Pharmacy Network Management Contact	Manager, Pharmacy Services		Perez	Charles		1-918-594-5295	6479				cperez@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4277	Pharmacy Technical Help Desk Contact	Supervisor, Pharmacy Services		Burke	Amy						1-918-794-4309	aburke@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active	1-877-293-8628	6808			PPO - BBA		C	Dallas
H4277	Plan to Plan Reconciliation Contact	Senior Financial Analyst		Mack	Lynda		1-918-594-5295	6320				lmack@ccok.com	Two West Second Street, Suite 100		Tulsa	OK	74103	02/02/2022	2023	CommunityCare Life & Health Insurance Co.	Local CCP	CommunityCare Options (PPO)	Local PPO		CommunityCare Managed Healthcare Plans of OK, Inc.	94	Yes	Active					PPO - BBA		C	Dallas
H4279	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		1-412-454-5539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		1-412-454-5559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	07/18/2016	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	CMS Casework Communication Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		1-412-454-5250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		1-412-454-7664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		1-412-454-8589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	08/29/2012	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	1-800-396-4139				HMO - Health Maintenance Organization		C	Philadelphia
H4279	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	10/31/2016	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4279	Pharmacy Technical Help Desk Contact	DIrector, Customer Service		Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	07/29/2021	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Philadelphia
H4279	Plan to Plan Reconciliation Contact	Business Analyst		Michalski	Jeff		1-412-454-5715				1-412-454-2110	medicarereporting@upmc.edu	c/o UPMC Health Plan Attn: Dave Soltesz P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	10/03/2022	2023	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4286	Automated TrOOP Balance Transfer Contact	COO		Hernandez	Henry		1-305-631-5855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	05/17/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Best Available Evidence Contact	COO		Hernandez	Henry		1-305-631-5855				1-305-718-2860	henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	09/10/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Chief Financial Officer	SVP & CFO	Ms.	Pardo	Ann Mary		1-305-631-5064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Yzquierdo	Milagros		1-305-631-5855					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	06/16/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Coordination of Benefits Contact	COO		Hernandez	Henry		1-305-631-5855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	05/17/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Customer Service Operations Contact	COO		Hernandez	Henry		1-305-631-5855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	05/17/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Government Relations Contact	President	Mr.	Maury	Albert		1-305-644-2135					albert.maury@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Hospice Contact	SVP & CMO		Mas	Rafael		1-305-642-5366					rafael.mas@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Yzquierdo	Milagros		1-305-631-5855					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	06/16/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Exceptions Contact	COO		Hernandez	Henry						1-305-646-3226	henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	05/17/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active	1-833-376-5366				HMO - Health Maintenance Organization		C	Atlanta
H4286	Pharmacy Network Management Contact	COO		Hernandez	Henry		1-305-631-5855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	05/17/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Pharmacy Technical Help Desk Contact	COO		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway CT		San Diego	CA	92131	11/14/2022	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active	1-800-681-7504				HMO - Health Maintenance Organization		C	Atlanta
H4286	Plan to Plan Reconciliation Contact	COO		Hernandez	Henry		1-305-631-5855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	05/17/2021	2023	LEON HEALTH, INC.	Local CCP	Leon Health Plans	HMO/HMOPOS		Leon Health Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4304	Automated TrOOP Balance Transfer Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	10/20/2020	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Best Available Evidence Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	10/20/2020	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Chief Financial Officer	Director Finance	Mr	Finlinson	Doug		1-801-587-2675					DOUG.FINLINSON@hsc.utah.edu	6053 Fashion Square Drive, Suite 110		Murray	UT	84107	02/06/2020	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	CMS Casework Communication Contact	Appeals Manager	Ms.	Willey	Katie		1-801-213-0291					Katie.Willey@hsc.utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	02/18/2022	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Coordination of Benefits Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	10/20/2020	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Customer Service Operations Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	02/23/2022	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Government Relations Contact	Compliance Manager	Mr.	Christensen	Eric		1-801-213-0292					eric.n.christensen@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	12/19/2022	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Hospice Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	10/20/2020	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Medicare Compliance Officer	Compliance Manager	Mr.	Christensen	Eric		1-801-213-0292					eric.n.christensen@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	12/19/2022	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Part D Exceptions Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David							David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	10/21/2020	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active	1-801-213-0099				PPO - BBA		C	Dallas
H4304	Pharmacy Network Management Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	10/21/2020	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4304	Pharmacy Technical Help Desk Contact	CVS Pharmacy Technical Help Desk		Help Desk	CVS								6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	05/20/2021	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active	1-866-693-4620				PPO - BBA		C	Dallas
H4304	Plan to Plan Reconciliation Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110	Attn: Finance Department (P2P)	Murray	UT	84107	10/19/2022	2023	UNIVERSITY OF UTAH HEALTH INSURANCE PLANS	Local CCP	University of Utah Health Insurance Plans	Local PPO		University of Utah	762	Yes	Active					PPO - BBA		C	Dallas
H4305	Automated TrOOP Balance Transfer Contact	Part D Manager		Summitt	Lori		1-870-207-7502				1-870-207-0571	lsummitt@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	08/23/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	Best Available Evidence Contact	Executive Director	CEO	McDaniel	Becky		1-870-207-7505				1-870-207-0527	bmcdaniel@sbrmc.org	505 E Matthews		Jonesboro	AR	72401	01/10/2020	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	Chief Financial Officer	Accountant	CFO	Domino	DeAnna	J	1-870-207-7526				1-870-207-0571	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	04/01/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	CMS Casework Communication Contact	Program Integrity Manager		Rowe	Shellei		1-870-207-7485				1-870-207-0527	srowe@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	07/28/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	Coordination of Benefits Contact	Medicare Part D Manager		Summitt	Lori		1-870-207-7502				1-870-207-0571	lsummitt@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	08/23/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	Customer Service Operations Contact	Center Manager	COO	Hayes	Tina		1-870-207-7503				1-870-207-0527	trhayes@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	Government Relations Contact	Executive Director	CEO	McDaniel	Becky		1-870-207-7505				1-870-207-0527	bmcdaniel@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	Medicare Compliance Officer	Program Integrity Manager	Mrs.	Rowe	Shellei		1-870-207-7485				1-870-207-0527	srowe@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	07/28/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	Part D Exceptions Contact	Medicare Part D Manager		Summitt	Lori						1-870-207-0571	lsummitt@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	08/23/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active	1-855-207-7502				PACE - Nat		C	Dallas
H4305	Pharmacy Network Management Contact	Center Manager		Hayes	Tina		1-870-207-7503				1-870-207-0571	trhayes@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	07/28/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4305	Pharmacy Technical Help Desk Contact	CFO		Domino	DeAnna						1-870-207-0527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	04/07/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active	1-855-207-7526				PACE - Nat		C	Dallas
H4305	Plan to Plan Reconciliation Contact	CFO		Domino	DeAnna		1-870-207-7526				1-870-207-0527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	04/07/2022	2023	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	Dallas
H4326	Automated TrOOP Balance Transfer Contact	Finance Specialist	Ms.	Martin	Ambra		1-828-468-3980	5313			1-828-994-4298	amartin@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Best Available Evidence Contact	Executive Director	Mrs.	Jones	Emily		1-828-468-3980	5335			1-828-464-2845	ejones@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Chief Financial Officer	Finance Manager	Mrs.	Balint	Nadine		1-828-468-3980	5304			1-828-994-4298	nbalint@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	CMS Casework Communication Contact	Executive Director	Mrs.	Jones	Emily		1-828-468-3980	5335			1-828-464-2845	ejones@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Coordination of Benefits Contact	Finance Specialist	Ms.	Martin	Ambra		1-828-468-3980	5313			1-828-994-4298	amartin@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Customer Service Operations Contact	Executive Director	Mrs.	Jones	Emily		1-828-468-3980	5335			1-828-464-2845	ejones@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Government Relations Contact	Executive Director	Mrs.	Jones	Emily		1-828-468-3980	5335			1-828-464-2845	ejones@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Medicare Compliance Officer	Quality and Compliance Coordinator	Mrs.	Morgan	Deborah		1-828-468-3980	5319			1-828-464-2845	dmorgan@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part D Exceptions Contact	Finance Specialist	Ms.	Martin	Ambra						1-828-994-4298	amartin@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active	1-828-468-3980	5313			PACE - Nat		C	Atlanta
H4326	Pharmacy Network Management Contact		Ms.	Slowiak	Andrea		1-715-852-2983					aslowiak@pharmastarpbm.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	03/07/2016	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Pharmacy Technical Help Desk Contact		Ms.	Brasberger	Lindsey							LBrasberger@carekinesis.com	228 Strawbridge Drive		Moorestown	NJ	08057	03/04/2019	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active	1-609-670-1034				PACE - Nat		C	Atlanta
H4326	Plan to Plan Reconciliation Contact	Finance Specialist	Ms.	Martin	Ambra		1-828-468-3980	5313			1-828-994-4298	amartin@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2023	PACE @ HOME, INC.	National PACE	PACE@Home	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4343	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	01/31/2020	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H4343	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4343	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H4343	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4346	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H4346	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4346	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H4346	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4393	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Services		Krupar	Roman		1-917-484-5060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	Best Available Evidence Contact	Asst. VP PACE		Adam Menard	Jackie		1-646-289-7763				1-646-219-5975	jadam@archcare.org	1432 5th Ave		New York	NY	10035	04/30/2021	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	Chief Financial Officer	Chief Financial Officer	Ms.	Covone	Annmarie		1-646-633-4702					acovone@chcsnet.org	205 Lexington Avenue	2nd Floor	New York	NY	10016	11/04/2016	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	CMS Casework Communication Contact	Vice President PACE		Rosado	Elizabeth		1-646-289-7772					erosado@archcare.org	1432 Fifth Avenue		New York	NY	10035	10/05/2021	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	Coordination of Benefits Contact	Asst. VP PACE	Mr.	Adam Menard	Jackie		1-646-289-7763				1-646-219-5975	jadam@archcare.org	1432 5th Ave		New York	NY	10035	04/30/2021	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	Customer Service Operations Contact	Advisor/Project Manager, Medicare D		Swanger	Rachel		1-440-542-4056					rachelswanger@caremark.com	CVS Caremark Part D Services, LCC.	29100 Aurora Road	Solon	OH	44139	08/20/2020	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	Government Relations Contact	Vice President PACE	Ms.	Rosado	Elizabeth		1-646-289-7700					erosado@archcare.org	1432 5th Ave		New York	NY	10032	04/05/2022	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	Medicare Compliance Officer	SVP, Compliance and Legal	Ms.	Strum	Sarah		1-646-633-4401					sstrum@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	04/05/2022	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	Part D Exceptions Contact	Director, Medicare Clinical Operations		Patel	Nimesh							NimeshC.Patel@CVSCaremark.com	CVS Caremark Part D Services, LCC.	29100 Aurora Road	Solon	OH	44139	01/19/2016	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active	1-440-542-5770				PACE - Nat		C	New York
H4393	Pharmacy Network Management Contact	Director, Network Systems & Standards		Tressler	Damon		1-480-391-4702				1-480-314-6023	damon.tressler@caremark.com	CVS Caremark Part D Services, LCC.	9501 E Shea Blvd., MC080	Scottsdale	AZ	85260	01/19/2016	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4393	Pharmacy Technical Help Desk Contact	Manager, Vendor Management		Palmieri	Mike						1-866-693-4620	Mike.Palmieri@caremark.com	CVS Caremark Part D Services, LCC.	2401 Cherahala Blvd., MC650	Knoxville	TN	37932	11/23/2021	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active	1-866-693-4620				PACE - Nat		C	New York
H4393	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Covone	Annmarie		1-646-633-4702					acovone@archcare.org	205 Lexington Ave.	2nd Floor	New York	NY	10016	11/04/2016	2023	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active					PACE - Nat		C	New York
H4402	Automated TrOOP Balance Transfer Contact	Senior Director of Finance-PACE	Mr.	Vieu	George		1-708-478-7943				1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	10/21/2020	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Best Available Evidence Contact	Medical Director	Dr.	Birch	Lorna		1-423-698-0802	1080188			1-423-622-6048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/04/2020	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Chief Financial Officer	Senior Director of Finance, PACE	Mr.	Vieu	George		1-708-478-7943					george.vieu@ascension.org	18927 Hickory Creek Drive	Suite 300	Mokena	IL	60448	05/24/2019	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	CMS Casework Communication Contact	Compliance director	Ms	Brown	Judith		1-423-495-9119				1-423-622-6048	judith.brown2@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/16/2021	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Coordination of Benefits Contact	Senior Director of Finance-PACE	Mr.	Vieu	George		1-708-478-7943				1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	10/21/2020	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Customer Service Operations Contact	Site Director	Ms	Herring	Beth		1-423-495-9104				1-423-495-9145	bherring@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	02/22/2022	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Government Relations Contact	QI Director	Ms	Brown	Judith		1-423-495-9119				1-423-622-6048	judith.brown2@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	08/12/2021	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Medicare Compliance Officer	Compliance Director	Ms	Brown	Judith		1-423-495-9119				1-423-697-1752	judith.brown2@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	04/27/2022	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part D Exceptions Contact	Senior Director of Finance PACE	Mr.	Vieu	George						1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	10/21/2020	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active	1-800-441-8883				PACE - Nat		C	Atlanta
H4402	Pharmacy Network Management Contact	Medical Director	Dr.	Birch	Lorna		1-423-698-0802	1080188			1-423-622-6048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanoga	TN	37404	09/04/2020	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Pharmacy Technical Help Desk Contact	Director of Pharmacy		McDonough	Leah						1-423-622-6048	lmcdonough@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	04/02/2018	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active	1-800-441-8883				PACE - Nat		C	Atlanta
H4402	Plan to Plan Reconciliation Contact	Claims Manager	Mr.	Stengele	Brett		1-815-529-1077				1-423-622-6048	brett.stengele@ascension.org	250 East 10th Street		Chattanooga	TN	37402	03/14/2022	2023	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Alexian Brothers Community Services	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4407	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H4407	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H4407	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4461	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H4461	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H4461	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4490	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/18/2020	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H4490	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4490	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-833-502-6757				HMO - Health Maintenance Organization		C	Dallas
H4490	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4497	Automated TrOOP Balance Transfer Contact			Goff	Katherine		1-216-687-7344					Katherine.Goff@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	06/02/2015	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Best Available Evidence Contact	Medicare Operations Analyst II		Crowley	Lauren		1-216-687-6585					BAEdocs@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	10/12/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Chief Financial Officer		Mr.	Mueller	Raymond		1-216-687-7828					raymond.mueller@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/17/2014	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	CMS Casework Communication Contact			Lee	Anissa		1-216-687-7059					Anissa.Lee@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/10/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Coordination of Benefits Contact	Director, Financial Payment and Review		Palace	Ted		1-216-687-2807					Ted.Palace@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	01/31/2019	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Customer Service Operations Contact	Dir, Customer Care		Lee	Anissa		1-216-687-7059	77059				Anissa.Lee@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	01/13/2020	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Government Relations Contact			Slee	Nicole		1-614-306-6271					Nicole.Slee@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/31/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Hospice Contact			Goff	Katherine		1-216-687-7344					Katherine.Goff@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	02/15/2018	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Slee	Nicole		1-614-306-6271					nicole.slee@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/31/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/14/2016	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	1-614-336-3326				PPO - BBA		C	Chicago
H4497	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	02/02/2015	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	4700 North Hanley		St. Louis	MO	63134	12/23/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H4497	Plan to Plan Reconciliation Contact			Stepic	Michelle		1-216-687-7151					Michelle.Stepic@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/04/2017	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4506	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H4506	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H4506	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4513	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H4513	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H4513	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4514	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/25/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H4514	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4514	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H4514	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4517	Automated TrOOP Balance Transfer Contact	Director of Finance		Houck	Jamie		1-806-374-5516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110-1026	03/20/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	Best Available Evidence Contact	Director of Finance		Houck	Jamie		1-806-374-5516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110-1026	03/20/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	Chief Financial Officer	Director of Finance	Mrs	Houck	Jamie		1-806-374-5516				1-806-373-9446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	11/05/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	CMS Casework Communication Contact	Director of Finance		Houck	Jamie		1-806-374-5516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110-1026	03/20/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	Coordination of Benefits Contact	Director of Finance		Houck	Jamie		1-806-374-5516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110-1026	03/20/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	Customer Service Operations Contact	Executive Director	Mrs	Hurt	Kristen	R	1-806-374-5516				1-806-373-9446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	Government Relations Contact	Executive Director	Mrs	Hurt	Kristen	R	1-806-374-5516				1-806-373-9446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	Medicare Compliance Officer	Compliance Coordinator	Ms	Gross	Stephanie		1-806-374-5516				1-806-373-9446	stephanie@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110-1026	07/22/2021	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	Part D Exceptions Contact	Finance Director	Ms	Houck	Jamie						1-806-373-9446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	03/20/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active	1-888-374-8400				PACE - Nat		C	Dallas
H4517	Pharmacy Network Management Contact	Executive Director	Mrs	Hurt	Kristen	R	1-806-374-5516				1-806-373-9446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4517	Pharmacy Technical Help Desk Contact	Director of Finance	Ms	Houck	Jamie						1-806-373-9446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	03/20/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active	1-888-299-6401				PACE - Nat		C	Dallas
H4517	Plan to Plan Reconciliation Contact	Director of Finance		Houck	Jamie		1-806-374-5516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110-1026	03/20/2020	2023	AMARILLO MULTISVC CTR FR THE AGING INC	National PACE	The Basics at Jan Werner	National PACE		Amarillo Multisvc Ctr Fr the Aging Inc	12	Yes	Active					PACE - Nat		C	Dallas
H4518	Automated TrOOP Balance Transfer Contact	Accounts Payable Manager		Garcia	Irene		1-915-562-3444	2370				Irene.Garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	12/17/2019	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	Best Available Evidence Contact	Accounting Supervisor		Garcia	Irene		1-915-562-3444	2370				igarcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	05/23/2016	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	Chief Financial Officer	VP of Finance	Mr	Ortiz	Luis		1-915-562-3444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	08/13/2021	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	CMS Casework Communication Contact	QI Manager	Ms.	Alvarado	Karla	L	1-915-562-3444	1603				karla.alvarado@bienvivir.org	2300 McKinley		El Paso	TX	79930	07/15/2022	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	Coordination of Benefits Contact	Accounts Payable Manager		Garcia	Irene		1-915-562-3444	2370				Irene.Garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	12/17/2019	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	Customer Service Operations Contact	VP of Center Operations	MR	Baca	James		1-915-562-3444	2240				jbaca@bienvivir.org	2300 McKinley		El Paso	TX	79930	10/30/2012	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	Government Relations Contact	VP of Finance	Mr	Ortiz	Luis		1-915-562-3444	2101				luiortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	10/28/2015	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	Medicare Compliance Officer	Compliance Officer	Mr	Barrera	Antonio		1-915-562-3444	1703				antonio.barrera@bienvivir.org	2300 McKinley		El Paso	TX	79930	02/23/2021	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	Part D Exceptions Contact	Director of Pharmacy		Orona	Robert							rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	10/30/2012	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active	1-915-562-3444	1801			PACE - Nat		C	Dallas
H4518	Pharmacy Network Management Contact	Director of Pharmacy		Orona	Robert		1-915-562-3444	1801				rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4518	Pharmacy Technical Help Desk Contact	Director of Pharmacy		Orona	Robert							rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active	1-915-562-3444	1801			PACE - Nat		C	Dallas
H4518	Plan to Plan Reconciliation Contact	VP of Finance	Mr	Ortiz	Luis		1-915-562-3444	2101				luiortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	10/28/2015	2023	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Dallas
H4523	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H4523	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4523	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H4523	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4527	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/07/2021	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H4527	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4527	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H4527	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4537	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H4537	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4537	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H4537	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4544	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Best Available Evidence Contact			Korndorffer	Gretchen		1-504-849-4500	8963				gretchen.korndorffer@peopleshealth.com	Three Lakeway Center	3838 North Causeway Boulevard, Suite 2200	Metairie	LA	70002	03/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	CMS Casework Communication Contact			Culotta	Dianne		1-504-849-4500	8672				dianne.culotta@peopleshealth.com	Three Lakeway Center	3838 North Causeway Boulevard, Suite 2200	Metairie	LA	70002	03/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Coordination of Benefits Contact			Kennedy	Sean		1-504-849-4500	8880				phn-pbmteam@peopleshealth.com	Three Lakeway Center	3838 North Causeway Boulevard, Suite 2200	Metairie	LA	70002	03/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Customer Service Operations Contact			Pecoul	Rose		1-504-849-4500	8776				rose.pecoul@peopleshealth.com	Three Lakeway Center	3838 North Causeway Boulevard, Suite 2200	Metairie	LA	70002	03/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	06/25/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H4544	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4544	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H4544	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/21/2020	2023	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4556	Chief Financial Officer	CFO	Mrs.	Ross	Tracy		1-254-773-1330	307			1-254-774-8029	tracyr@carehealthplan.com	P.O. Box 6130		Temple	TX	76503-6130	01/30/2019	2023	CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES HC	HCPP - 1833 Cost	Consolidated Assoc Of Railroad Employees Hc	HCPP - 1833 Cost		Consolidated Assoc of Railroad Employees HC	67	No	Active					HCPP		1	Dallas
H4556	CMS Casework Communication Contact	Medicare Coordinator	Mrs.	Hampton	Kathy		1-254-773-1330	268			1-254-774-8029	kathyh@carehealthplan.com	P.O. Box 6130		Temple	TX	76503-6130	08/16/2016	2023	CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES HC	HCPP - 1833 Cost	Consolidated Assoc Of Railroad Employees Hc	HCPP - 1833 Cost		Consolidated Assoc of Railroad Employees HC	67	No	Active					HCPP		1	Dallas
H4556	Customer Service Operations Contact	Medicare Coordinator	Mrs.	Hampton	Kathy		1-254-773-1330	268			1-254-774-8029	kathyh@carehealthplan.com	P.O. Box 6130		Temple	TX	76503-6130	08/16/2016	2023	CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES HC	HCPP - 1833 Cost	Consolidated Assoc Of Railroad Employees Hc	HCPP - 1833 Cost		Consolidated Assoc of Railroad Employees HC	67	No	Active					HCPP		1	Dallas
H4556	Government Relations Contact	Medicare Coordinator	Mrs.	Hampton	Kathy		1-254-773-1330	268			1-254-774-8029	kathyh@carehealthplan.com	P.O. Box 6130		Temple	TX	76503-6130	08/16/2016	2023	CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES HC	HCPP - 1833 Cost	Consolidated Assoc Of Railroad Employees Hc	HCPP - 1833 Cost		Consolidated Assoc of Railroad Employees HC	67	No	Active					HCPP		1	Dallas
H4556	Medicare Compliance Officer	Medicare Coordinator	Mrs.	Hampton	Kathy		1-254-773-1330	268			1-254-774-8029	kathyh@carehealthplan.com	P.O. Box 6130		Temple	TX	76503-6130	08/16/2016	2023	CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES HC	HCPP - 1833 Cost	Consolidated Assoc Of Railroad Employees Hc	HCPP - 1833 Cost		Consolidated Assoc of Railroad Employees HC	67	No	Active					HCPP		1	Dallas
H4590	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H4590	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4590	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H4590	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H4604	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4604	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2020	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H4604	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4605	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				PPO - BBA		C	Seattle
H4605	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4605	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				PPO - BBA		C	Seattle
H4605	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H4620	Automated TrOOP Balance Transfer Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Best Available Evidence Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Chief Financial Officer	Chief Financial Officer	Mr.	Grabski	Ben		1-763-300-7611					bgrabski@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	CMS Casework Communication Contact	Sr. Director Compliance	Mr.	Whitbeck	Britton		1-314-209-3989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Coordination of Benefits Contact			Inquiries	COB		1-855-425-0457					COBInquiry@lumeris.com	P O BOX 5907		TROY	MI	48007	12/06/2022	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoffer	Linda		1-636-686-9682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		1-314-209-2717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Hospice Contact	Director, Pharmacy		Cruz	Jennifer		1-314-770-3556					pharmacy@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Medicare Compliance Officer	VP Internal Audit and Chief Compliance Officer	Ms.	Venable	Erin		1-314-209-3957					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Part D Exceptions Contact		Ms.	Byers	June							June.Byers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				PPO - BBA		C	Kansas City
H4620	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4620	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				PPO - BBA		C	Kansas City
H4620	Plan to Plan Reconciliation Contact	Manager, Client Payments		Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF OHIO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H4623	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H4623	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H4623	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4624	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/11/2020	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Best Available Evidence Contact	COO	Mr.	Collins	GARFIELD		1-312-319-5468				1-312-319-5468	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Chief Financial Officer	CFO	Mr.	Sahin	Mete		1-703-282-5955					mete.sahin@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	CMS Casework Communication Contact	CMO	Dr.	Haywood	Trent		1-312-203-0642					trent.haywood@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Coordination of Benefits Contact	COO	Mr.	Collins	GARFIELD		1-312-319-5468				1-312-319-5468	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Customer Service Operations Contact	V.P. Customer Service	Ms.	Coyle	Gina		1-312-809-8079	183			1-312-809-8079	gina.coyle@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Government Relations Contact	Communication	Mr..	Martin	Stephen		1-312-205-7948	138				stephen.martin@myzing.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Hospice Contact	CMO	Dr.	Haywood	Trent		1-312-203-0642					trent.haywood@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Matuszak	Russell		1-312-832-6676	292			1-312-832-6676	russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Part D Exceptions Contact	Pharmacy Project Manager		Santaya	Carlos							carlos.santaya@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	01/01/2023	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	1-312-477-0778				HMO - Health Maintenance Organization		C	Chicago
H4624	Pharmacy Network Management Contact	Director Pharmacy Network Development and Operatio		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	01/01/2023	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4624	Pharmacy Technical Help Desk Contact	V.P. Operations		Conn	Todd							tconn@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	01/01/2023	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	1-855-476-6993				HMO - Health Maintenance Organization		C	Chicago
H4624	Plan to Plan Reconciliation Contact	CFO	Mr.	Sahin	Mete		1-703-282-5955					mete.sahin@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4626	Automated TrOOP Balance Transfer Contact			Cheng	David		1-562-508-7380					dcheng@scanhealthplan.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	Best Available Evidence Contact			Cheng	David		1-562-508-7380					dcheng@scanhealthplan.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	Chief Financial Officer		Mr.	Pottharst	Robert		1-323-989-9912					regulatory@prosperservices.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	CMS Casework Communication Contact			Cheng	David		1-562-508-7380					dcheng@scanhealthplan.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	Coordination of Benefits Contact			Cheng	David		1-562-508-7380					dcheng@scanhealthplan.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	Customer Service Operations Contact			Cheng	David		1-562-508-7380					dcheng@scanhealthplan.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	Government Relations Contact		Mr.	Pottharst	Robert		1-323-989-9912					regulatory@prosperservices.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	Medicare Compliance Officer		Mr.	Pottharst	Robert		1-323-989-9912					regulatory@prosperservices.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	Part D Exceptions Contact			Cheng	David							dcheng@scanhealthplan.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending	1-562-508-7380				PACE - Nat		C	San Francisco
H4626	Pharmacy Network Management Contact			Cheng	David		1-562-508-7380					dcheng@scanhealthplan.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4626	Pharmacy Technical Help Desk Contact			Cheng	David							dcheng@scanhealthplan.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending	1-562-508-7380				PACE - Nat		C	San Francisco
H4626	Plan to Plan Reconciliation Contact	CEO	Mr.	Pottharst	Robert		1-323-989-9912					regulatory@prosperservices.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/20/2022	2023	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4652	Chief Financial Officer	CFO	Mr.	Barnett	Greg		1-801-595-4372				1-801-595-2037	gbarnett@ironroad.com	1040 North 2200 West Suite 200		Salt Lake City	UT	84116	11/03/2022	2023	UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS	HCPP - 1833 Cost	Union Pacific Railroad Employes Health Systems	HCPP - 1833 Cost		Union Pacific Railroad Employes Health Systems	243	No	Active					HCPP		1	Denver
H4652	CMS Casework Communication Contact	Director Care Management		Newman	Curtis		1-801-595-4470				1-801-595-2070	cneuman@uphealth.com	1040 North 2200 West Suite 200		Salt Lake City	UT	84116	04/10/2018	2023	UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS	HCPP - 1833 Cost	Union Pacific Railroad Employes Health Systems	HCPP - 1833 Cost		Union Pacific Railroad Employes Health Systems	243	No	Active					HCPP		1	Denver
H4652	Customer Service Operations Contact	Manager of Customer Services		Hayes	Tonya		1-801-595-4300				1-801-595-2087	thayes@uphealth.com	1040 North 2200 West Suite 200		Salt Lake City	UT	84116	08/03/2016	2023	UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS	HCPP - 1833 Cost	Union Pacific Railroad Employes Health Systems	HCPP - 1833 Cost		Union Pacific Railroad Employes Health Systems	243	No	Active					HCPP		1	Denver
H4652	Government Relations Contact	CMS Compliance Officer		Puff-Newberry	Andrea		1-801-595-4337				1-801-595-2037	apnewberry@uphealth.com	1040 North 2200 West Suite 200		Salt Lake City	UT	84116	01/26/2018	2023	UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS	HCPP - 1833 Cost	Union Pacific Railroad Employes Health Systems	HCPP - 1833 Cost		Union Pacific Railroad Employes Health Systems	243	No	Active					HCPP		1	Denver
H4652	Medicare Compliance Officer	Corporate Compliance Officer	Ms.	Puff-Newberry	Andrea		1-801-595-4337				1-801-595-2037	apnewberry@uphealth.com	1040 North 2200 West Suite 200		Salt Lake City	UT	84116	07/27/2017	2023	UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS	HCPP - 1833 Cost	Union Pacific Railroad Employes Health Systems	HCPP - 1833 Cost		Union Pacific Railroad Employes Health Systems	243	No	Active					HCPP		1	Denver
H4675	Automated TrOOP Balance Transfer Contact	Manager, PBM Ops.	Ms.	Hanson	Michelle		1-612-777-6755					EOBP2P@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	10/06/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Best Available Evidence Contact	Supervisor, Govt. Programs		Achoe	Kisha		1-973-466-7328					BaeInquiries@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	01/03/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Chief Financial Officer	CFO	Mr.	Meaney	Frank		1-203-525-6777					Frank.Meaney@BravenHealth.com	3 Penn Plaza East		Newark	NJ	07105	01/03/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	CMS Casework Communication Contact	Director, GP Operations		Maramraju	Venkata		1-609-537-2113					venkata.maramraju@horizonblue.com	1700 American Boulevard		Pennington	NJ	08534	01/03/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Coordination of Benefits Contact	Manager, PBM Ops	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6705	COBMedD@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	10/06/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Customer Service Operations Contact	Director, Operations - GP		Yanek	John		1-518-220-8000					john_yanek@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	06/13/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Government Relations Contact	Medicare Compliance Officer	Ms.	Keehn	Lisa		1-646-221-4210					lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	04/30/2021	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Hospice Contact	Manager, Clinical Pharmacy		Sun	Jane		1-973-466-5044					Jane_Sun@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	01/03/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Keehn	Lisa		1-646-221-4210					lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	04/14/2021	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Part D Exceptions Contact	Director, Reg/Audit Response	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd		Eagan,	MN	55121	04/15/2021	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	New York
H4675	Pharmacy Network Management Contact	AVP, Network Mgmt	Ms	Conlin	Marci		1-612-777-2842					Marci.Conlin@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	04/15/2021	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4675	Pharmacy Technical Help Desk Contact	Director, Member Services		Shultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	12/30/2022	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active	1-800-391-1926				HMO - Health Maintenance Organization		C	New York
H4675	Plan to Plan Reconciliation Contact	Pharmacy Business Admin		Cunningham	Theresa		1-973-466-7886				1-973-466-4665	theresa_cunningham@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	01/23/2020	2023	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	HMO/HMOPOS		NJ Collaborative Care, LLC	755	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4676	Automated TrOOP Balance Transfer Contact	Director of Pharmacy		Yon	Keith		1-704-275-8900	128				keith@troymedicare.com	615 S. College St.	FL 10	Charlotte	NC	28202	03/07/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Best Available Evidence Contact	Chief Financial Officer	Mr.	Mohawk	Russ		1-704-275-8900	115				russ@troymedicare.com	615 S College Street	9 Fl	Charlotte	NC	28202	10/29/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Chief Financial Officer	Chief Financial Officer	Mr.	Mohawk	Russ		1-704-275-8900	115				russ@troymedicare.com	615 S College Street	9 Fl	Charlotte	NC	28202	09/22/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Scott	Sally		1-704-275-8900	168				sally@troymedicare.com	615 S. College St	10F	Charlotte	NC	28202	05/04/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Coordination of Benefits Contact	Chief Financial Officer	Mr.	Mohawk	Russ		1-704-275-8900	115				russ@troymedicare.com	615 S College Street	9 Fl	Charlotte	NC	28202	10/29/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Customer Service Operations Contact	Chief Operating Officer	Mrs.	Eisenberg	Elyse		1-704-275-8900	112				elyse@troymedicare.com	615 S. College St	10F	Charlotte	NC	28202	02/12/2019	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Government Relations Contact			Harrison	Scott		1-703-697-0339					srharrison@srhlaw.us	1200 G St., NW	Suite 800	Washington	DC	20005	02/10/2019	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Hospice Contact	Dr.		Terrell	Jennifer		1-704-534-0045					jennifer@troymedicare.com	615 S College St Fl 10		Charlotte	NC	28202	02/15/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Scott	Sally		1-704-275-8900	168				sally@troymedicare.com	615 S. College St	10F	Charlotte	NC	28202	04/26/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Exceptions Contact	Director of Pharmacy		Yon	Keith							keith@troymedicare.com	615 S. College St.	FL 10	Charlotte	NC	28202	03/07/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active	1-704-275-8900	128			HMO - Health Maintenance Organization		C	Atlanta
H4676	Pharmacy Network Management Contact	Director of Pharmacy		Yon	Keith		1-704-275-8900	128				keith@troymedicare.com	615 S. College St.	FL 10	Charlotte	NC	28202	03/07/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Pharmacy Technical Help Desk Contact			Pharmacy Services	PerformRx								200 Stevens Dr.		Philadelphia	PA	19113	06/02/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active	1-866-560-6052				HMO - Health Maintenance Organization		C	Atlanta
H4676	Plan to Plan Reconciliation Contact	Vice President of Finance	Mr.	Shandley	Joey		1-704-275-8900	116				joey@troymedicare.com	615 S College Street	10 Fl	Charlotte	NC	28202	05/04/2022	2023	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4682	Automated TrOOP Balance Transfer Contact	Director of Finance		Cordeau	Bryan		1-202-603-9602					bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Best Available Evidence Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Chief Financial Officer		Mr	Cordeau	Bryan		1-202-603-9602					Bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	CMS Casework Communication Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Coordination of Benefits Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Customer Service Operations Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Government Relations Contact		Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		los Angles	CA	90018	07/25/2022	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Medicare Compliance Officer		Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		los Angles	CA	90018	07/25/2022	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Exceptions Contact	Director of Finance		Cordeau	Bryan							bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending	1-202-603-9602				PACE - Nat		C	San Francisco
H4682	Pharmacy Network Management Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Pharmacy Technical Help Desk Contact	Director of Finance		Cordeau	Bryan							bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending	1-202-603-9602				PACE - Nat		C	San Francisco
H4682	Plan to Plan Reconciliation Contact	Director of Finance		Cordeau	Bryan		1-202-603-9602					bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	Concertocare PACE of Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4699	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H4699	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4699	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H4699	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H4711	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/11/2018	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H4711	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4711	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H4711	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4714	Automated TrOOP Balance Transfer Contact	CFO		Nickerson	Kirby		1-704-754-8228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Jr. Ave.		Salisbury	NC	28145	01/11/2021	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	Best Available Evidence Contact	CEO/President	Ms.	Rizzuti	Renee		1-704-887-3857				1-704-887-3844	renee.rizzuti@pacesp.com	6133 The Plaza		Charlotte	NC	28215	09/14/2020	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	Chief Financial Officer	Chief Financial Officer	Mr.	Nickerson	Kirby		1-704-754-8228				1-704-637-2950	knickerson@LSCarolinas.net	1416 S. Martin Luther King Jr. Ave.		Salisbury	NC	28145	09/14/2020	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	CMS Casework Communication Contact	CEO/President	Ms.	Rizzuti	Renee		1-704-887-3840	3857			1-704-887-3844	renee.rizzuti@pacesp.com	6133 The Plaza		Charlotte	NC	28215	09/14/2020	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	Coordination of Benefits Contact	CFO	Mr.	Nickerson	Kirby		1-704-754-8228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Jr. Ave.		Salisbury	NC	28145	01/11/2021	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	Customer Service Operations Contact	CEO/President	Ms.	Rizzuti	Renee		1-704-887-3857				1-704-887-3844	renee.rizzuti@pacesp.com	6133 The Plaza		Charlotte	NC	28215	09/14/2020	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	Government Relations Contact	CEO/President	Ms.	Rizzuti	Renee		1-704-887-3857				1-704-887-3844	renee.rizzuti@pacesp.com	6133 The Plaza		Charlotte	NC	28215	09/14/2020	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	Medicare Compliance Officer	Compliance Officer/Health Data Special	Mr.	Powell	Greg		1-336-745-6346					greg.powell@pacesp.com	6133 The Plaza		Charlotte	NC	28215	09/14/2020	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	Part D Exceptions Contact	Health Data Specialist	Mr.	Powell	Greg							greg.powell@LSCarolinas.net	6133 The Plaza		Charlotte	NC	28215	01/11/2021	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active	1-704-887-3857				PACE - Nat		C	Atlanta
H4714	Pharmacy Network Management Contact	Health Data Specialist		Powell	Greg		1-704-887-3857					Greg.Powell@pacesp.com	6133 The Plaza		Charlotte	NC	28215	01/11/2021	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4714	Pharmacy Technical Help Desk Contact	Health Data Specialist	Ms.	Powell	Greg						1-704-887-3844	greg.powell@pacesp.com	6133 The Plaza		Charlotte	NC	28215	09/14/2020	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active	1-704-887-3840	3846			PACE - Nat		C	Atlanta
H4714	Plan to Plan Reconciliation Contact	Health Data Specialist	Mr.	Powell	Greg		1-704-887-3857					greg.powell@pacesp.com	6133 The Plaza		Charlotte	NC	28215	01/11/2021	2023	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active					PACE - Nat		C	Atlanta
H4733	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		1-858-790-5873					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Best Available Evidence Contact	Enrollment Manager		Fernandez	Judith		1-619-498-6418				1-619-426-9437	jferna@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Chief Financial Officer	Chief Financial Officer	Mr.	Carroll	Scott		1-619-498-6591				1-619-425-7803	scarro@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	CMS Casework Communication Contact	Member Services Director		Waters	David		1-619-498-6420					dwaters@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Coordination of Benefits Contact	Pharmacist		Chung	Tammy		1-619-240-8888				1-619-382-1217	ttran@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/30/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Customer Service Operations Contact	Member Services Director		Waters	David		1-619-498-6420					dwaters@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Government Relations Contact	Associate CEO		Warren	Ann		1-619-498-6516				1-619-422-5930	awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Hospice Contact	Senior Director of Healthcare Services		Farook	Yousaf		1-619-498-6540					yfaroo@chgsd.com	2420 Fenton Street		Chula Vista	CA	91914	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Medicare Compliance Officer	Compliance Officer	Ms.	Martinez	Elizabeth		1-619-498-6490				1-619-422-5930	emarti@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Part D Exceptions Contact	Pharmacist		Chung	Tammy						1-619-382-1217	ttran@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/30/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	1-888-244-4430				HMO - Health Maintenance Organization		C	San Francisco
H4733	Pharmacy Network Management Contact	Pharmacist		Chung	Tammy		1-619-240-8888				1-619-382-1217	ttran@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/30/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4733	Pharmacy Technical Help Desk Contact	VP, Customer Contact Services		Battle	Dorry						1-858-790-6075	Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/03/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	1-888-648-6758				HMO - Health Maintenance Organization		C	San Francisco
H4733	Plan to Plan Reconciliation Contact	Pharmacist		Chung	Tammy		1-619-240-8888					ttran@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/30/2022	2023	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4739	Automated TrOOP Balance Transfer Contact	Manager, Technical Delivery & Oversight	Mr.	Gajarajan	Nivi		1-267-825-8648					ngajarajan2@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/29/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		1-484-497-1171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Chief Financial Officer	Chief Financial Officer	Mr.	Burgoyne	Michael		1-215-937-8875					mburgoyne@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	100 Stevens Drive	Philadelphia	PA	19113	02/12/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	CMS Casework Communication Contact	Medicare QA Contract Acct Mgr	Ms.	Fine	Nicole		1-484-496-7479					nfine@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	10/17/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Coordination of Benefits Contact	Manager, Provider Network Oversight	Ms.	Williams	Kathy		1-843-746-7499					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		1-267-298-1794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	08/04/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Government Relations Contact	VP, Government Relations		Cozzo	Mr.Steven		1-215-937-8236					scozzo@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	11/17/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Hospice Contact	Director of Pharmacy, Medicare	Ms.	Shepard	Jen		1-215-937-8685					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	11/17/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Solomon	Mary		1-267-300-4846					mlsolomon@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	100 Stevens Drive, 2flr.	Philadelphia	PA	19113	01/14/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						1-215-863-5100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/12/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-215-863-6483				HMO - Health Maintenance Organization		C	Philadelphia
H4739	Pharmacy Network Management Contact	Manager, Pharmacy Network Operations	Mr.	King	James		1-843-569-4845					jking@performrx.com	PerformRx	200 Stevens Dr.	Philadelphia	PA	19113	07/28/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4739	Pharmacy Technical Help Desk Contact	Director, Service Operations	Ms.	Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/12/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-855-327-0511				HMO - Health Maintenance Organization		C	Philadelphia
H4739	Plan to Plan Reconciliation Contact	Director, Medicare Performance Management	Mr.	Kindred	Amanda		1-248-404-5991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4754	Automated TrOOP Balance Transfer Contact	VP, Government Operations		Hannabach	Jane		1-541-330-2530					Jane.Hannabach@pacificsource.com	PO Box 7469		Bend	OR	97708	12/17/2021	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Best Available Evidence Contact	VP, Government Operations		Hannabach	Jane		1-541-330-2530					Jane.Hannabach@pacificsource.com	PO Box 7469		Bend	OR	97708	12/17/2021	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Chief Financial Officer	Executive VP and Chief Financial Officer (CFO)	Mr.	Davidson	Peter		1-541-684-5212				1-541-385-3008	Peter.Davidson@pacificsource.com	555 International Way		Springfield	OR	97477	09/16/2020	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	CMS Casework Communication Contact	Team Leader Appeals and Grievances		Downey	Reanna		1-541-706-5031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Coordination of Benefits Contact	Claims Manager COB-TPL		Keeler	Dena		1-541-225-3765					Dena.Keeler@pacificsource.com	555 International Way		Springfield	OR	97477	04/14/2022	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Customer Service Operations Contact	VP, Government Operations		Hannabach	Jane		1-541-330-2530				1-541-385-3008	Jane.Hannabach@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Government Relations Contact	Director, Government Compliance	Ms.	Brown	Jennifer		1-541-330-8115				1-541-385-3008	Jennifer.Brown@pacificsource.com	PO Box 7469		Bend	OR	97708	10/08/2020	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Hospice Contact	Administrative Programs Manager		Riffle	Connie		1-541-330-7309				1-541-385-3008	Connie.Riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Medicare Compliance Officer	Compliance Manager	Mrs.	Brown	Jennifer		1-541-330-8115				1-541-385-3008	Jennifer.Brown@pacificsource.com	PO Box 7469		Bend	OR	97708	10/07/2022	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Part D Exceptions Contact	Pharmacy Services Leadership Team		Services	Pharmacy							RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active	1-541-330-4999				PPO - BBA		C	Seattle
H4754	Pharmacy Network Management Contact	SR. Manager, PBM Financial Operations		Okrie	Courtney		1-480-318-1864					Courtney.Okrie@CVSHealth.com	9501 E. Shea Blvd, MC080		Scottsdale	AZ	85620	01/06/2022	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4754	Pharmacy Technical Help Desk Contact	Government Programs Pharmacy Services		Services	Pharmacy							pharmacyservices-government@pacificsource.com	PO Box 7469		Bend	OR	97708	04/08/2016	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active	1-888-437-7728				PPO - BBA		C	Seattle
H4754	Plan to Plan Reconciliation Contact	Enrollment and Billing Representative		Yeakey	Paula		1-541-706-5172					P2Padmin@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2023	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Seattle
H4801	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	02/16/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/15/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	02/15/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/15/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				PPO - BBA		C	Denver
H4801	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4801	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				PPO - BBA		C	Denver
H4801	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H4808	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H4808	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4808	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H4808	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4829	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H4829	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4829	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H4829	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/21/2020	2023	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H4835	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/11/2018	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/06/2019	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H4835	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4835	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H4835	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4847	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H4847	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4847	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H4847	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4863	Automated TrOOP Balance Transfer Contact	General Counsel/SVP of Health Plan Administration	Mr.	Brown	Ryan	D	1-931-560-0041	2449				rbrown@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/08/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Best Available Evidence Contact	General Counsel/SVP of Health Plan Administration	Mr.	Brown	Ryan	D	1-931-560-0041	2449				rbrown@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/08/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Chief Financial Officer	Chief Financial Officer	Mrs.	Adams	Renee		1-931-560-0041	3108				radams@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/08/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	CMS Casework Communication Contact	Assistant General Counsel & VP of Compliance	Mr.	Beard	Jason		1-931-560-0041	3125				jbeard@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/08/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Coordination of Benefits Contact	Chief Operating Officer	Mrs.	Graham	Miranda		1-931-560-0041	6206				mgraham@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/09/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Customer Service Operations Contact	Chief Operating Officer	Mrs.	Graham	Miranda		1-931-560-0041	6206				mgraham@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/09/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Government Relations Contact	General Counsel/SVP of Health Plan Administration	Mr.	Brown	Ryan	D	1-931-560-0041	2449				rbrown@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/08/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Hospice Contact	Executive Medical Director-Government Programs	Dr.	Pomerantz	Jay		1-919-710-0431					jpomerantz@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/09/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Tutaj	Thomas		1-931-560-0041	6461				ttutaj@fbhp.com	P.O. Box 313		Columbia	TN	38402	05/04/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Part D Exceptions Contact	Executive Medical Director-Government Programs	Dr.	Pomerantz	Jay							jpomerantz@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/09/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active	1-919-710-0431				HMO - Health Maintenance Organization		C	Atlanta
H4863	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	02/09/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4863	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summer	Todd							todd.summers@optum.com	755 Research Parkway Suite 300		Oklahoma City	OK	73104	02/09/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active	1-866-643-6924				HMO - Health Maintenance Organization		C	Atlanta
H4863	Plan to Plan Reconciliation Contact	General Counsel/SVP of Health Plan Administration	Mr.	Brown	Ryan	D	1-931-560-0041	2449				rbrown@fbhp.com	P.O. Box 313		Columbia	TN	38402	02/08/2022	2023	TRH HEALTH INSURANCE COMPANY	Local CCP	Farm Bureau Health Plans	HMO/HMOPOS		Tennessee Rural Health Improvement Association	651	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4868	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/07/2022	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H4868	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4868	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H4868	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF NEW YORK, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4869	Automated TrOOP Balance Transfer Contact	VP of Clinical Affairs		Sorensen	Kirsten		1-512-585-3376					kirsten.sorensen@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85255	09/23/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Best Available Evidence Contact	VP of Clinical Affairs		Sorensen	Kirsten		1-512-585-3376					kirsten.sorensen@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85255	09/23/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Chief Financial Officer	CFO	Mr,	Jain	Amit		1-669-388-0003					amit.jain@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	CMS Casework Communication Contact	CEO	Mr,	Firdaus	Dave		1-917-545-5439					dave.firdaus@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Coordination of Benefits Contact	CIO	Mr,	Shankar	Ravi		1-990-026-2055	91				ravi@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Customer Service Operations Contact	VP Claims & Configuration		Moore	Stephanie	T	1-813-435-8154					Stephanie.Moore@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Government Relations Contact	CEO		Firdaus	Dave		1-917-545-5439					dave.firdaus@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Hospice Contact	VP of Clinical Affairs		Sorensen	Kirsten		1-512-585-3376					kirsten.sorensen@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Medicare Compliance Officer	Audit and Compliance Officer	Mr.	Leon	Francisco		1-813-847-5561					francisco.leon@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Part D Exceptions Contact	Director of Pharmacy		Haggit	Brian							Brian.Haggit@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active	1-602-696-1796				HMO - Health Maintenance Organization		C	San Francisco
H4869	Pharmacy Network Management Contact	Director of Pharmacy		Haggit	Brian		1-602-696-1796					Brian.Haggit@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4869	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/30/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active	1-888-672-7206				HMO - Health Maintenance Organization		C	San Francisco
H4869	Plan to Plan Reconciliation Contact	CFO	Mr,	Jain	Amit		1-669-388-0003					amit.jain@goldkidney.com	8502 E Princess Dr, #260		Scottsdale	AZ	85260	10/17/2022	2023	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4875	Automated TrOOP Balance Transfer Contact	Enrollment Coordinator		Rice	Lori		1-616-464-8667					PH-MedicareTrOOPContact@PriorityHealth.com	1231 East Beltline Ave NE	MS 1175	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Best Available Evidence Contact	Manager, Medicare Enrollment		Thomas	Sabrina		1-616-464-8578					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Chief Financial Officer	Chief Financial Officer	Mr	Gates	Nick	P	1-616-464-8144					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	CMS Casework Communication Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		1-917-841-7869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/14/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Coordination of Benefits Contact	Claims Manager		Ball	Jill		1-888-389-6648					CEOMedicare@priorityhealth.com	1239 East Beltline Ave NE	MS2205	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Customer Service Operations Contact	Customer Care Center Manager, Medicare		Storment	Joe		1-503-330-9550					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/07/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Government Relations Contact	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Hospice Contact	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Medicare Compliance Officer	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					charles.baker@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Part D Exceptions Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active	1-800-466-6642				PPO - BBA		C	Chicago
H4875	Pharmacy Network Management Contact	Director Pharmacy Operations		Chaffee	Jacob		1-616-575-6149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4875	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active	1-800-466-6642				PPO - BBA		C	Chicago
H4875	Plan to Plan Reconciliation Contact	Reconciliation & Billing Specialist		Bentley-Brown	Linda		1-616-464-8582				1-616-957-3420	linda.bentley-brown@priorityhealth.com	1231 East Beltline Ave NE	MS 1190	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Chicago
H4882	Automated TrOOP Balance Transfer Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	1-952-883-6536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Best Available Evidence Contact	Manager Membership Accounting		Marty	Amanda	E	1-952-967-7685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	55440-1309	11/05/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Chief Financial Officer	EVP & Chief Financial Officer	Ms.	Cermak	Penny	D	1-952-883-7918					penny.d.cermak@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	55440-1309	09/13/2022	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	CMS Casework Communication Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	1-952-967-7679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	55440-9463	12/02/2022	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Coordination of Benefits Contact	Manager, Claims Production		Prine	Chantelle	M	1-952-967-7335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	55440-1309	04/20/2022	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Customer Service Operations Contact	Director Member Services		Renneke	Alison		1-952-967-7668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	55440-9463	01/29/2020	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Government Relations Contact	VP Government Programs		Clelland	Jennifer	J	1-952-967-5119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	55440-1309	08/30/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Hospice Contact	Pharmacy Compliance Specialist		Riggs	Ben	H	1-952-851-8421					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Medicare Compliance Officer	VP Internal Audit Comp Officer	Mr.	Bunde	Steven	D	1-952-883-6541				1-952-883-5522	steven.d.bunde@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	12/03/2021	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part D Exceptions Contact	Supervisor, Clinical Review		Whelan	Hillary	A					1-888-883-5434	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	1-800-492-7259				PPO - BBA		C	Chicago
H4882	Pharmacy Network Management Contact	Director Pharmacy Sales & Product Support		Friday	Ken	R	1-952-967-5826				1-952-967-6667	kenneth.r.friday@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Pharmacy Technical Help Desk Contact	Manager Health Plan Pharmacy Customer Service		Whelan	Hillary	A					1-888-883-5434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/19/2022	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	1-800-492-7259				PPO - BBA		C	Chicago
H4882	Plan to Plan Reconciliation Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	1-952-883-6584				1-952-883-6500	kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	55440-1309	01/24/2017	2023	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4906	Chief Financial Officer	Administrator	Ms	Hoke	Michelle	M	1-540-862-5728				1-540-862-4958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2023	C AND O EMPLOYEES' HOSPITAL ASSOCIATION	HCPP - 1833 Cost	C and O Employees' Hospital Association	HCPP - 1833 Cost		C & O Employees' Hospital Association	37	No	Active					HCPP		1	Philadelphia
H4906	CMS Casework Communication Contact	Benefits Manager	Mrs	Via	Brandi		1-540-862-5728				1-540-862-4958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2023	C AND O EMPLOYEES' HOSPITAL ASSOCIATION	HCPP - 1833 Cost	C and O Employees' Hospital Association	HCPP - 1833 Cost		C & O Employees' Hospital Association	37	No	Active					HCPP		1	Philadelphia
H4906	Customer Service Operations Contact	Medicare Dues Clerk		Nicely	Rodney		1-800-679-9135				1-540-862-4958	Rodney@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2023	C AND O EMPLOYEES' HOSPITAL ASSOCIATION	HCPP - 1833 Cost	C and O Employees' Hospital Association	HCPP - 1833 Cost		C & O Employees' Hospital Association	37	No	Active					HCPP		1	Philadelphia
H4906	Government Relations Contact	Benefits Manager	Mrs	Via	Brandi		1-540-862-5728				1-540-862-4958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2023	C AND O EMPLOYEES' HOSPITAL ASSOCIATION	HCPP - 1833 Cost	C and O Employees' Hospital Association	HCPP - 1833 Cost		C & O Employees' Hospital Association	37	No	Active					HCPP		1	Philadelphia
H4906	Medicare Compliance Officer	Benefits Manager	Mrs	Via	Brandi		1-540-862-5728				1-540-862-4958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2023	C AND O EMPLOYEES' HOSPITAL ASSOCIATION	HCPP - 1833 Cost	C and O Employees' Hospital Association	HCPP - 1833 Cost		C & O Employees' Hospital Association	37	No	Active					HCPP		1	Philadelphia
H4909	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H4909	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4909	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H4909	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4919	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	Best Available Evidence Contact	Director of PACE Finance	Mr.	Ewing	Mark		1-303-869-4664				1-303-996-1600	mewing@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	Chief Financial Officer	CFO	Mrs.	Gutierrez	Barbara		1-303-869-4664				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	CMS Casework Communication Contact	Acting Compliance Officer	Ms	Walton	Vanessa		1-303-869-4664				1-303-996-1600	Vwalton2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	03/17/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-303-869-4664				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	Customer Service Operations Contact	Regional Director of Quality	Ms.	Curry	Jill		1-303-869-4664				1-303-996-1600	jcurry@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	03/17/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	Government Relations Contact	Vice President Regulatory Affairs	Mrs.	Dahan	Beverley		1-303-869-4664				1-303-996-1600	bdahan@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	Medicare Compliance Officer	VP of Pharmacy Services	Mrs.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	Part D Exceptions Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending	1-720-974-6785				PACE - Nat		C	Atlanta
H4919	Pharmacy Network Management Contact	VP of Pharmacy Services	Mrs.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4919	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending	1-720-974-6785				PACE - Nat		C	Atlanta
H4919	Plan to Plan Reconciliation Contact	Medicare Compliance Manager		Brown	Lauren		1-303-869-4664				1-720-917-3390	lbrown2@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	01/28/2021	2023	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H4922	Automated TrOOP Balance Transfer Contact	MANAGING DIRECTOR – FINANCE, ANALYTICS AND OPERATI		Giarraputo	Marybeth		1-718-484-5028					mgiarraputo@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	12/21/2021	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Best Available Evidence Contact	MANAGING DIRECTOR – FINANCE, ANALYTICS AND OPERATI		Giarraputo	Marybeth		1-718-484-5028					mgiarraputo@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	12/21/2021	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Chief Financial Officer	Chief Financial Officer	Mr.	Murphy	Joseph		1-718-484-5011					jmurphy@agewellnewyork.com	1991 Marcus Avenue	Suite M201	Lake Success	NY	11042	07/31/2015	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	CMS Casework Communication Contact	Corporate Compliance Officer	Ms.	Mukuka	Barbra		1-718-484-5032					bmukuka@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	01/09/2017	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Coordination of Benefits Contact	MANAGING DIRECTOR – FINANCE, ANALYTICS AND OPERATI		Giarraputo	Marybeth		1-718-484-5028					mgiarraputo@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	12/21/2021	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Customer Service Operations Contact	Director, Enrollment and Clinical Assessment		Komsic	Linda		1-718-484-5040					lkosmic@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	12/23/2019	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Government Relations Contact	Corporate Compliance Officer		Mukuka	Barbra	I	1-718-484-5032					bmukuka@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	12/08/2016	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Hospice Contact	Director, Pharmacy		Zhang	Cecilia		1-718-484-5000	5178				czhang@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	08/25/2021	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Medicare Compliance Officer	Corporate Compliance Officer	Ms.	Mukuka	Barbra		1-718-484-5032					bmukuka@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	12/23/2016	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Part D Exceptions Contact	Director, Pharmacy		Zhang	Cecilia							CZhang@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	08/25/2021	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active	1-186-658-6804				HMO - Health Maintenance Organization		C	New York
H4922	Pharmacy Network Management Contact	Director Pharmacy Network Contracting		Profio	Lauren		1-330-405-8094					lprofio@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	06/08/2022	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4922	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							tconn@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	06/08/2022	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active	1-844-782-7670				HMO - Health Maintenance Organization		C	New York
H4922	Plan to Plan Reconciliation Contact	Chief Financial Officer		Murphy	Joseph		1-718-484-5011					APAgeWellNY@agewellnewyork.com	1991 Marcus Ave	Suite M201	Lake Success	NY	11042	10/19/2015	2023	AGEWELL NEW YORK, LLC	Local CCP	AgeWell New York	HMO/HMOPOS		ParkerCare New York, LLC	534	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Automated TrOOP Balance Transfer Contact	Supervisor Financial Analysis Consultant	Mr	Marshall	Gregory		1-480-684-5209					Gregory.Marshall@bannerhealth.com	2901 N. Central Ave Ste. 160		Phoenix	AZ	85012	09/27/2022	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Best Available Evidence Contact	Medicare Enrollment Sr. Mgr.	Mrs	Paredes	Nadya		1-520-874-5964				1-520-874-7083	Nadya.Paredes@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	01/26/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Chief Financial Officer	Chief Financial Officer	Mr.	Aubrey	Rob		1-832-540-2074					Rob.Aubrey@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	04/27/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	CMS Casework Communication Contact	Director, Grievance and Appeals	Mr	Maccioli	James		1-520-874-3247				1-520-874-7083	James.Maccioli2@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	12/20/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Coordination of Benefits Contact	Director Reimbursement Services		Groves	Lori		1-602-469-2249					Lori.Groves@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/30/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Customer Service Operations Contact	Customer Care Director	Mrs	Carrillo	Veronica		1-520-874-5349				1-520-874-7083	Veronica.Carrillo@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	01/26/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Government Relations Contact	Government Programs Sr. Director	Mr.	Thomsen	Ryan		1-520-780-8310					ryan.thomsen@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	04/19/2022	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Hospice Contact	Pharmacy Director	Mr	Pokorney	Tim		1-602-747-2101					Timothy.Pokorney@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	09/27/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Medicare Compliance Officer	Compliance Senior Director	Ms	Corlette	Kristina		1-602-747-2431					BMAComplianceOfficer@BannerHealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/05/2022	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Part D Exceptions Contact	Express Scripts Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	Express Scripts	5151 Blazer Pkwy	Dublin	OH	43017	12/21/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	San Francisco
H4931	Pharmacy Network Management Contact	Express Scripts Network Accountant Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	12/21/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4931	Pharmacy Technical Help Desk Contact	Express Scripts (Director, Customer Services)		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	Express Scripts	13051 N Telecom PKWY STE 150	Temple Terrace	FL	33637	12/16/2022	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active	1-800-864-1406				HMO - Health Maintenance Organization		C	San Francisco
H4931	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Aubrey	Rob		1-832-540-2074					Rob.Aubrey@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	07/09/2021	2023	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage Dual	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H4937	Automated TrOOP Balance Transfer Contact	Senior Manager, Medicare Operations		Halley	Derek		1-818-228-6374					Derek.Halley@blueshieldca.com	6300 Canoga Ave,		Woodland Hills	CA	91367	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Best Available Evidence Contact	Manager, Medicare Operations		Loreto	Alfonso		1-818-228-7005					Alfonso.Loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Chief Financial Officer	Senior Director, Medicare Finance	Mr.	Ballou	Taylor		1-818-228-6697					Taylor.Ballou@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		1-818-228-2651					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Coordination of Benefits Contact	Manager, Medicare Operations		Loreto	Alfonso		1-818-228-7005					alfonso.loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/02/2019	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Customer Service Operations Contact	Operations Specialist, Consultant		Lopez	Cynthia		1-818-228-6251					Cynthia.Lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Government Relations Contact	Senior Manager, Medicare Compliance		Mata	Marcos		1-818-228-6048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Hospice Contact	Senior Program Manager		Fields	Torrie		1-415-229-5839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	01/02/2019	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		1-818-228-7028					Richard.Robinson@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Part D Exceptions Contact	Director, Pharmacy Prior Authorization		March	Nancee							nancee.march@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active	1-800-776-4466				PPO - BBA		C	San Francisco
H4937	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		1-510-607-2901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4937	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active	1-888-970-0933				PPO - BBA		C	San Francisco
H4937	Plan to Plan Reconciliation Contact	Financial Analyst Consultant		Dahl	Chris		1-818-228-2575					BSCP2PRecon@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	San Francisco
H4943	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Bush	Stephen		1-254-298-3568				1-254-298-3005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Best Available Evidence Contact	Director HP Enrollment		Wilson	Deanna		1-254-298-3340					Deanna.Wilson@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/24/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Chief Financial Officer	Chief Financial Officer	Mr.	Bush	Stephen	P	1-254-298-3568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	CMS Casework Communication Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Coordination of Benefits Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Customer Service Operations Contact	Manager, Customer Advocacy		Perkins	Michelle		1-254-298-3393					Michelle.Perkins@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Government Relations Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Hospice Contact	Director Pharmacy Operations		Luebbert	Charlotte		1-254-298-6151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Medicare Compliance Officer	Compliance Officer	Mrs	Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Part D Exceptions Contact	Manager Pharmacy Admin.		Thomas	Megan							Megan.Cunningham@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active	1-254-298-6108				HMO - Health Maintenance Organization		C	Dallas
H4943	Pharmacy Network Management Contact	Director Pharmacy Operations		Luebbert	Charlotte		1-254-298-6151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4943	Pharmacy Technical Help Desk Contact	OptumRx		Rx	Optum								1600 McConnor Parkway		Schaumburg	IL	60173-6801	01/14/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active	1-844-230-9357				HMO - Health Maintenance Organization		C	Dallas
H4943	Plan to Plan Reconciliation Contact	Chief Financial Officer		Bush	Stephen		1-254-298-3568				1-254-298-3005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	Scott & White Care Plans	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4961	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	06/02/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	08/25/2020	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/02/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	06/02/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/02/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				PPO - BBA		C	San Francisco
H4961	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	02/03/2022	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4961	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/21/2021	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				PPO - BBA		C	San Francisco
H4961	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	02/05/2019	2023	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H4982	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/11/2018	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/06/2019	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H4982	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4982	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H4982	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H4999	Automated TrOOP Balance Transfer Contact	VP Quality Finance	Mrs.	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street , Suite 201		Erie	PA	16507	08/01/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Best Available Evidence Contact	VP Quality Finance	Mrs.	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street , Suite 201		Erie	PA	16507	08/01/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Chief Financial Officer	CFO	Mr.	Phillips	Jeffery		1-814-456-5433					jphillips@lifenwpa.org	100 State Street, Suite 201		Erie	PA	16507	08/01/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	CMS Casework Communication Contact	CEO	Mr.	Fish	Richard		1-814-456-5433					rfish@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street   Suite 201	Erie	PA	16507	03/22/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Coordination of Benefits Contact	VP Quality Finance	Mrs.	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street , Suite 201		Erie	PA	16507	08/01/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Customer Service Operations Contact	Director of Center Operation	Mrs.	Kraus	Lisa		1-814-456-5433					MedD-CM@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street, Suite 201	Erie	PA	16507	03/22/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Government Relations Contact	CEO	Mr.	Fish	Richard		1-814-456-5433					rfish@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street   Suite 201	Erie	PA	16507	03/22/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Medicare Compliance Officer	Director of Quality	Ms	McClure	Shelby		1-814-413-1495					smcclure@lifenwpa.org	100 State Street , suite 201		Erie	PA	16507	03/22/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Part D Exceptions Contact	VP Contracts-Part D	Mr.	Feldmann	William							HPMS-MedD@lifenwpa.org	100 State Street, Suite 201		Erie	PA	16507	08/01/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	1-814-456-5433				PACE - Nat		C	Philadelphia
H4999	Pharmacy Network Management Contact	Medical Director	Dr.	Shaffer	Kevin		1-814-456-5433					kshaffer@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street, Suite 201	Erie	PA	16507	03/22/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Shaffer	Kevin							kshaffer@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street, Suite 201	Erie	PA	16507	03/22/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	1-814-456-5433				PACE - Nat		C	Philadelphia
H4999	Plan to Plan Reconciliation Contact	VP Quality Finance	Mrs.	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street , Suite 201		Erie	PA	16507	08/01/2022	2023	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H5007	Automated TrOOP Balance Transfer Contact	PACE Health Plan Data Analyst		Chambers	Perry		1-503-215-3672				1-503-215-0685	perry.chambers@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Best Available Evidence Contact			Wachsmuth	Rosalie		1-503-215-3681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/25/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Chief Financial Officer		Ms	Barr	Natalie		1-503-215-3859					natalie.barr@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	01/27/2021	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	CMS Casework Communication Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		1-503-215-3681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	01/28/2021	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Coordination of Benefits Contact	PACE Health Plan Data Analyst		Chambers	Perry		1-503-215-3672				1-503-215-0685	perry.chambers@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Customer Service Operations Contact	PACE Health Plan Data Analyst		Chambers	Perry		1-503-215-3672				1-503-215-0685	perry.chambers@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Government Relations Contact			Noordijk	Cindy		1-503-215-4124					cynthia.noordijk@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	02/25/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Medicare Compliance Officer	Manager, Quality, Compliance & Education	Ms.	Vemuri	Susan		1-206-760-6414				1-206-760-6339	Susan.Vemuri@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Exceptions Contact	PACE Health Plan Data Analyst		Chambers	Perry						1-503-215-0685	perry.chambers@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active	1-503-215-3672				PACE - Nat		C	Seattle
H5007	Pharmacy Network Management Contact			Schultz	Elizabeth		1-425-525-6908					Elizabeth.Schultz@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Pharmacy Technical Help Desk Contact			Service	Customer							Rosalie.Wachsmuth@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active	1-888-445-5518				PACE - Nat		C	Seattle
H5007	Plan to Plan Reconciliation Contact	PACE Health Plan Data Analyst		Chambers	Perry		1-503-215-3672				1-503-215-0685	perry.chambers@providence.org	2811 South 102nd St, Suite 210		Tukwila	WA	98168	08/09/2022	2023	PROVIDENCE HEALTH SYSTEM	National PACE	Providence Health System	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5008	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H5008	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5008	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H5008	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5009	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				PPO - BBA		C	Seattle
H5009	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5009	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				PPO - BBA		C	Seattle
H5009	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				PPO - BBA		C	Seattle
H5010	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5010	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				PPO - BBA		C	Seattle
H5010	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	ASURIS NORTHWEST HEALTH	Local CCP	Asuris Northwest Health	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Seattle
H5015	Automated TrOOP Balance Transfer Contact	Pharmacy Director		Luu	Cindy		1-361-484-9214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Best Available Evidence Contact	Enrollment & Billing Manager		Rhodes	Shmonica		1-361-827-6546					srhodes@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Chief Financial Officer	CFO	Mr.	Dekowski	Donovan		1-361-576-0694					DDekowski@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	CMS Casework Communication Contact	Member Services/A&G Manager		Clay	Lori		1-361-827-6215					lclay2@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Coordination of Benefits Contact	Financial Analyst		Batchelder	Holly		1-361-576-0694					hbatchelder@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Customer Service Operations Contact	VP of Operations		Spencer	Caroline		1-361-827-8970				1-361-333-1587	cspencer@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Government Relations Contact	President & CEO	Mr.	Dekowski	Devan		1-361-649-1371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Hospice Contact	Member Services/A&G Manager		Clay	Lori		1-361-827-6215					lclay2@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Gifford	Tammy		1-361-676-8119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Part D Exceptions Contact	Vice President of Clinial Operations		Lavignette	Amanda							alavignette@envisionrx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	11/10/2020	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H5015	Pharmacy Network Management Contact	Director of Pharmacy Network Contracting	Ms	Profio	Laura		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/07/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5015	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 201	Twinsburg	OH	44087	09/07/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active	1-866-213-1594				HMO - Health Maintenance Organization		C	Dallas
H5015	Plan to Plan Reconciliation Contact	Financial Analyst		Batchelder	Holly		1-361-576-0694					hbatchelder@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2023	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5037	Automated TrOOP Balance Transfer Contact	Center Manager	Ms	Collinsworth	Tara		1-276-523-0599	310			1-276-523-6483	tara.collinsworth@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/01/2022	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	Best Available Evidence Contact	PACE Director and COO	Ms	Greer	Ruth		1-276-523-0599	310			1-276-523-6483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	Chief Financial Officer	CFO	Ms.	Sprinkle	Stephanie		1-423-306-8354				1-276-523-4208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	12/21/2021	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	CMS Casework Communication Contact	PACE Director and COO	Ms	Greer	Ruth		1-276-523-0599	310			1-276-523-6483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	Coordination of Benefits Contact	Administrative Specialist	Ms.	Turner	Bethany		1-276-523-0599	306			1-276-523-6483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	11/26/2018	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	Customer Service Operations Contact	PACE Director and COO	Ms	Greer	Ruth		1-276-523-0599	310			1-276-523-6483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	Government Relations Contact	PACE Director and COO	Ms	Greer	Ruth		1-276-523-0599	310			1-276-523-6483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	Medicare Compliance Officer	PACE Director and COO	Ms	Greer	Ruth		1-276-523-0599	310			1-276-523-6483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	Part D Exceptions Contact	PACE Director and COO	Ms	Greer	Ruth						1-276-523-6483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active	1-866-793-7223				PACE - Nat		C	Philadelphia
H5037	Pharmacy Network Management Contact	PACE Director and COO	Ms	Greer	Ruth		1-276-523-0599	310			1-276-523-6483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5037	Pharmacy Technical Help Desk Contact	Director of Information Technology	Mr.	Aguirre	Walter						1-276-523-4208	waguirre@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/04/2021	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active	1-866-793-7223	479			PACE - Nat		C	Philadelphia
H5037	Plan to Plan Reconciliation Contact	CFO	Ms.	Sprinkle	Stephanie		1-276-523-4202				1-276-523-4208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2023	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active					PACE - Nat		C	Philadelphia
H5042	Automated TrOOP Balance Transfer Contact	Pharmacy Compliance Coordinator		Bedell	Luke		1-518-641-4664				1-518-641-4605	luke.bedell@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Best Available Evidence Contact	Manager, Membership & Billing		Salzer	Cheryl		1-518-641-4170					cheryl.salzer@cdphp.com	500 Patroon Creek Blvd.		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Chief Financial Officer	Medicare Compliance Officer	Mr	Schoonmaker	Dennis		1-518-641-5275				1-518-641-4006	dennis.schoonmaker@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	CMS Casework Communication Contact	Medicare Compliance Officer		Schoonmaker	Dennis		1-518-641-5275				1-518-641-4605	dennis.schoonmaker@cdphp.com	500 Patroon Creek Corporate Center		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Coordination of Benefits Contact	Medicare Reimbursement Coordinator		Moye	Nancy		1-518-641-5274				1-518-641-4605	Medicare_Compliance_Inquiries@cdphp.com	500 Patroon Creek Corporate Center		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Customer Service Operations Contact	Director, Member Services		Kordas	Laura		1-518-641-3710				1-518-641-3507	laura.kordas@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Government Relations Contact	VP Communications and External Affairs		Skinner	Ali		1-518-641-5035				1-518-641-5506	ali.skinner@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Hospice Contact	Pharmacy Compliance Coordinator		Bedell	Luke		1-518-641-4664					luke.bedell@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Medicare Compliance Officer	Medicare Compliance Officer	Mr	Schoonmaker	Dennis	M	1-518-641-5275				1-518-641-4605	dennis.schoonmaker@cdphp.com	500 Patroon Creek Corporate Center		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Part D Exceptions Contact	Lead Managed Care Pharmacist		Reed	Lisa						1-518-641-3208	lisa.reed@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active	1-518-641-3231				PPO - BBA		C	New York
H5042	Pharmacy Network Management Contact	Vice President of Pharmacy & Health Quality Pgrms		Wood	Eileen		1-518-641-3215				1-518-641-3508	eileen.wood@cdphp.com	500 Patroon Creek Blvd		Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5042	Pharmacy Technical Help Desk Contact	Director, Customer Care		Ellerhorst	Lisa							lellerhorst@cap-rx.com	228 Park Avenue South	Suite 87234	New York	NY	10003	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active	1-833-599-1018				PPO - BBA		C	New York
H5042	Plan to Plan Reconciliation Contact	Dir. Risk Adjustment and Recovery		Nasadoski	Tom		1-518-641-4601				1-518-641-4102	P2PADMIN@cdphp.com	Attn Risk Management - P2P	500 Patroon Creek Blvd	Albany	NY	12206	12/31/2022	2023	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Capital District Physicians' Health Plan, Inc.	42	Yes	Active					PPO - BBA		C	New York
H5050	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	1-562-367-0592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Best Available Evidence Contact	Medicare Marketing & Enrollment Specialist	Mr.	Anderson	John		1-206-630-4260				1-206-877-0655	john.l.anderson@kp.org	PO Box 9813, Bldg RCB, Mail Stop RCB-C1W-04	1300 SW 27th St,  Bldg RCB, Mail Stop RCB-C1W-04	Renton	WA	98057-9055	08/06/2018	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Chief Financial Officer	Vice President & Chief Financial Officer	Ms.	Shepler	Courtney	R	1-510-271-4644					courtney.r.shepler@kp.org	National Medicare Finance, 1 Kaiser Plaza, 13th Floor	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	06/02/2017	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	CMS Casework Communication Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	1-720-527-9215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Coordination of Benefits Contact	Senior Director		Chung	Clarence		1-562-390-9293				1-562-658-3866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Customer Service Operations Contact	Operations Manager	Ms.	Lucas	Barbara		1-206-550-1626					Barbara.J.Lucas@kp.org	Naches Ave-SW. 2715		Renton	WA	98057-9055	04/08/2022	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Government Relations Contact	Senior Vice President, Government Relations	Mr.	Barrueta	Anthony	A	1-510-271-6835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/07/2021	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Hospice Contact	Membership Administration Technical Support	Mr.	Wells	John		1-206-630-2740					John.M.Wells@kp.org	PO Box 9010, Bldg RCR, Mail Stop RCR-A1E-07	2715 Naches Ave. SW, Bldg RCR, Mail Stop RCR-A1E-07	Renton	WA	98057-9010	08/06/2018	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Medicare Compliance Officer	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	1-720-527-9215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Part D Exceptions Contact	Manager, Pharmacy Ancillary Services	Ms.	Maktabi	Noushin						1-206-901-4410	Noushin.Maktabi@kp.org	PO Box 9009, Bldg RCA, Mail Stop RCA-B2N-02	2921 Naches Ave. SW, Bldg RCA, Mail Stop RCA-B2N-02	Renton	WA	98057-9009	08/06/2018	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-800-729-1174				HMO - Health Maintenance Organization		C	San Francisco
H5050	Pharmacy Network Management Contact	Manager, Pharmacy Medicare Programs	Mr.	Conway	Collin		1-206-630-1088				1-206-901-4410	Collin.S.Conway@kp.org	PO Box 9009, Bldg RCA,  Mail Stop RCA-B2N-02	2921 Naches Ave. SW,  Bldg RCA,  Mail Stop RCA-B2N-02	Renton	WA	98057-9009	12/01/2020	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5050	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Ancillary Services	Ms.	Maktabi	Noushin						1-206-901-4410	Noushin.Maktabi@kp.org	PO Box 9009, Bldg RCA, Mail Stop RCA-B2N-02	2921 Naches Ave. SW, Bldg RCA, Mail Stop RCA-B2N-02	Renton	WA	98057-9009	08/06/2018	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-800-729-1174				HMO - Health Maintenance Organization		C	San Francisco
H5050	Plan to Plan Reconciliation Contact	Director, National Medicare & Medicaid Finance		Callender	Margaret		1-510-433-6709					margaret.callender@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	09/01/2017	2023	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5080	Automated TrOOP Balance Transfer Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	Best Available Evidence Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	Chief Financial Officer	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	CMS Casework Communication Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@srpathways.com	134 Mary Hill Road		Phoenixville	PA	19460	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	Coordination of Benefits Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	Customer Service Operations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@srpathways.com	134 Mary Hill Road		Phoenixville	PA	19460	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	Government Relations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@srpathways.com	134 Mary Hill Road		Phoenixville	PA	19460	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	Medicare Compliance Officer	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@srpathways.com	134 Mary Hill Road		Phoenixville	PA	19460	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	Part D Exceptions Contact	CFO		Prentis	Kristin							kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending	1-732-806-3224				PACE - Nat		C	Chicago
H5080	Pharmacy Network Management Contact	Executive Director		Friedman	Pinni		1-732-592-3400					Pfriedman@acutecarehs.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5080	Pharmacy Technical Help Desk Contact	Executive Director		Friedman	Pinni							Pfriedman@acutecarehs.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending	1-732-592-3400				PACE - Nat		C	Chicago
H5080	Plan to Plan Reconciliation Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	12/10/2021	2023	BOLDAGE PACE INDIANA	National PACE	BoldAge PACE Indiana	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5085	Automated TrOOP Balance Transfer Contact	Executive Director		Berry	Sarah		1-231-652-4618					sberry@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	07/12/2021	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	Best Available Evidence Contact	Quality  Director	Mrs	Marquardt	Malorie		1-800-689-6675				1-231-689-5038	mmarquardt@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	04/26/2022	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	Chief Financial Officer	Financial Officer	Mrs.	Berry	Sarah		1-231-652-4618				1-231-652-4620	sberry@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	04/26/2022	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	CMS Casework Communication Contact	Clinic Director	Mrs	Gustman	Melanie		1-800-689-6675				1-231-689-5038	mmarquardt@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	04/26/2022	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	Coordination of Benefits Contact	Executive Director	Mrs.	Berry	Sarah		1-231-652-4618				1-231-652-4620	sberry@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	07/12/2021	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	Customer Service Operations Contact	Marketing/Intake Specialist	Mrs	Genther	Jaymie		1-231-652-4618				1-231-652-4620	jgenther@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	12/18/2020	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	Government Relations Contact	Executive Director	Mrs.	Berry	Sarah		1-231-652-4618				1-231-652-4620	sberry@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	07/12/2021	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	Medicare Compliance Officer	Executive Director	Mrs	Berry	Sarah		1-231-652-4618				1-231-652-4620	sberry@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	12/30/2021	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	Part D Exceptions Contact	Executive Director		Berry	Sarah						1-231-652-4620	sberry@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	07/12/2021	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active	1-231-652-4618				PACE - Nat		C	Kansas City
H5085	Pharmacy Network Management Contact	Executive Director		Berry	Sarah		1-231-652-4618				1-231-652-4620	sberry@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	07/12/2021	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5085	Pharmacy Technical Help Desk Contact	Clinical Director	Mrs	Gustman	Melanie						1-231-652-4620	mgustman@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	04/26/2022	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active	1-231-652-4618				PACE - Nat		C	Kansas City
H5085	Plan to Plan Reconciliation Contact	Executive Director		Berry	Sarah		1-231-652-4618				1-231-652-4620	sberry@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	07/12/2021	2023	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active					PACE - Nat		C	Kansas City
H5087	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/07/2022	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5087	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5087	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H5087	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5106	Automated TrOOP Balance Transfer Contact	Manager, Enrollment & Billing	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Chief Financial Officer	CFO Highmark Health Plan	Mr.	Veach	Daryl		1-412-544-7531					Daryl.Veach@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	1-412-544-4579				1-717-635-4209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		1-412-544-4417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		1-814-871-6712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Government Relations Contact	SVP, Government Affiars	Mr.	Warfel	Michael	G	1-717-302-3979					michael.warfel@highmark.com	1800 Center St.		Camp Hill	PA	17011	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Hospice Contact	Intake Coordinator		Welker	Jessica		1-717-888-3043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		1-412-544-7031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active	1-800-344-3405	733326			PPO - BBA		C	Philadelphia
H5106	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5106	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active	1-800-922-1557				PPO - BBA		C	Philadelphia
H5106	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	1-717-302-2748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 890407	Camp Hill	PA	17089-0407	12/20/2022	2023	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5117	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5117	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5117	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H5117	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5124	Automated TrOOP Balance Transfer Contact	Finance Manager	Mr.	Johnson	Andy		1-317-782-8007				1-317-782-6992	Andy.Johnson@franciscanalliance.org	700 East Southport Rd		Indianapolis	IN	46227	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	Best Available Evidence Contact	Interim PACE Administrative Director	Ms.	Escobedo	Kace		1-317-528-8933					Kace.Escobedo@franciscanalliance.org	8325 E. Southport Rd, Suite 120		Indianapolis	IN	46259	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	Chief Financial Officer	Chief Financial Officer	Mr	Wessel	Mark		1-317-705-4530					mark.wessel@franciscanalliance.org	4527 East 82nd Street		Indianapolis	IN	46250	09/05/2017	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	CMS Casework Communication Contact	Director of PACE	Mrs.	Matthys	Laura		1-219-864-2630					laura.matthys@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	11/16/2021	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	Coordination of Benefits Contact	Interim PACE Administrative Director	Ms.	Escobedo	Kace		1-317-528-8933					Kace.Escobedo@franciscanalliance.org	8325 E. Southport Rd, Suite 120		Indianapolis	IN	46259	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	Customer Service Operations Contact	Interim PACE Administrative Director	Ms.	Escobedo	Kace		1-317-528-8933					Kace.Escobedo@franciscanalliance.org	8325 E. Southport Rd, Suite 120		Indianapolis	IN	46259	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	Government Relations Contact	Interim PACE Administrative Director	Ms.	Escobedo	Kace		1-317-528-8933					Kace.Escobedo@franciscanalliance.org	8325 E. Southport Rd, Suite 120		Indianapolis	IN	46259	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	Medicare Compliance Officer	Compliance Officer	Ms	Heim	Joy		1-317-782-8009					Joy.Heim@franciscanalliance.org	700 East Southport Rd		Indianapolis	IN	46227	01/23/2017	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	Part D Exceptions Contact	Interim PACE Administrative Director	Ms.	Escobedo	Kace							Kace.Escobedo@franciscanalliance.org	8325 E. Southport Rd, Suite 120		Indianapolis	IN	46259	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active	1-317-528-8933				PACE - Nat		C	Chicago
H5124	Pharmacy Network Management Contact	Interim PACE Administrative Director	Ms.	Escobedo	Kace		1-317-528-8933					Kace.Escobedo@franciscanalliance.org	8325 E. Southport Rd, Suite 120		Indianapolis	IN	46259	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5124	Pharmacy Technical Help Desk Contact	Interim PACE Administrative Director	Ms.	Escobedo	Kace							Kace.Escobedo@franciscanalliance.org	8325 E. Southport Rd, Suite 120		Indianapolis	IN	46259	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active	1-317-528-8933				PACE - Nat		C	Chicago
H5124	Plan to Plan Reconciliation Contact	Interim PACE Administrative Director	Ms.	Escobedo	Kace		1-317-528-8933					Kace.Escobedo@franciscanalliance.org	8325 E. Southport Rd, Suite 120		Indianapolis	IN	46259	07/12/2022	2023	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	Chicago
H5140	Automated TrOOP Balance Transfer Contact			Esp	Brian		1-858-790-6445					partdcat@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/12/2019	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Best Available Evidence Contact	Mgr- Medicare Enrollment		Ramirez	Michelle		1-602-916-8404					michelle.ramirez@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	05/29/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Chief Financial Officer	Chief Financial Officer	Mr.	El-Tawil	Mark		1-602-864-5700					mark.el-tawil@azblue.com	8220 N 23rd Ave	MS C410	Phoenix	AZ	85021	02/12/2019	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	CMS Casework Communication Contact	Director, Corporate and Medicare Compliance		Moore	Veronica		1-602-336-7600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/29/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Coordination of Benefits Contact	Mgr- Medicare Finance		Nguyen	Peter		1-602-916-8506					peter.nguyen@azblue.com	10835 N 25th Ave		Phoenix	AZ	85029	05/29/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Customer Service Operations Contact	Staff VP, MA Ops & FEP Progs		Setzer	Stephanie	S	1-602-864-5726					stephanie.setzer@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	06/08/2022	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Government Relations Contact	VP & General Manager Medicare & FEP		Bowers	Krista		1-818-219-7755					krista.bowers@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	01/12/2022	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Hospice Contact	Sr Health Plan Rx Specialist		Norman	Laci		1-602-916-8577					laci.norman@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	05/29/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Medicare Compliance Officer	Director, Corporate and Medicare Compliance	Mrs.	Moore	Veronica		1-602-336-7600				1-602-864-3152	veronica.moore@azblue.com	8220 N 23rd Avenue		Phoenix	AZ	85021	02/11/2021	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Part D Exceptions Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Weideman	Stacy							Stacy.Weideman@azblue.com	10835 N 25th Ave. Ste 108		Phoenix	AZ	85029	12/16/2022	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-602-864-4391				PPO - BBA		C	San Francisco
H5140	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	MedImpact	10181 Scripps Gateway Ct .	San Diego	CA	92131	02/12/2019	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5140	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct .		San Diego	CA	92131	11/16/2022	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-877-403-6038				PPO - BBA		C	San Francisco
H5140	Plan to Plan Reconciliation Contact	Director, Financial Reporting		Acquafredda	Brandy		1-602-864-4683				1-602-864-5308	brandy.acquafredda@azblue.com	PO Box 81049		Phoenix	AZ	85069	05/29/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	Local PPO		Blue Cross Blue Shield of Arizona	447	Yes	Active					PPO - BBA		C	San Francisco
H5141	Automated TrOOP Balance Transfer Contact	Finance Manager		Harte	Declan		1-253-306-7269					declan.harte@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	04/07/2022	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Best Available Evidence Contact	Enrollment Dir	Ms	Newman	Jennifer		1-754-245-6377					jennifer.newman@cloverhealth.com	30 Montgomery Street, 15th floor		Jersey City	NJ	07302	07/18/2022	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Chief Financial Officer	Interim CFO	Mr.	Herbers	Mark		1-630-862-9384				1-201-255-4173	mark.herbers@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	08/16/2021	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	CMS Casework Communication Contact	Compliance Director	Mr.	Davis	Robert		1-201-320-0506					robert.davis@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	11/06/2019	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Coordination of Benefits Contact	Enrollment Director	Ms.	Newman	Jennifer		1-754-245-6377					jennifer.newman@cloverhealth.com	30 Montgomery Street , 15th floor		Jersey City	NJ	07302	07/18/2022	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Customer Service Operations Contact	Chief Operating Officer	Ms	Reynoso	Jamie		1-201-432-2133				1-201-255-4173	jamie.reynoso@Cloverhealth.com	30 Montgomery  St		Jersey City	NJ	07302	03/22/2021	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Government Relations Contact	Chief Compliance Officer	Mrs.	Richey	Wendy		1-551-225-2014				1-201-255-4173	wendy.richey@cloverhealth.com	3401 Mallory Lane Ste 210		Franklin	TN	37067	10/28/2021	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Hospice Contact	COO	Ms	Reynoso	Jamie		1-201-432-2133				1-201-858-7355	jamie.reynoso@Cloverhealth.com	30 Montgomery  St		Jersey City	NJ	07302	03/22/2021	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Richey	Wendy		1-551-225-2014				1-201-255-4173	wendy.richey@cloverhealth.com	3401 Mallory Lane Ste 210		Franklin	TN	37067	10/28/2021	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part D Exceptions Contact	VP of Pharmacy	Mr	Pica	Michael						1-201-255-4173	mike.pica@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	09/18/2017	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active	1-201-432-2133				PPO - BBA		C	New York
H5141	Pharmacy Network Management Contact	SV Pharmacy	Mr.	Pica	Mike		1-201-432-2133				1-480-314-6023	mike.pica@Cloverhealth.com	30 Montgomery  St	MC080	Jersey City	NJ	07302	11/06/2019	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Pharmacy Technical Help Desk Contact	VP of Pharmacy	Mr	Pica	Michael							mike.pica@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	06/21/2021	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H5141	Plan to Plan Reconciliation Contact	Sr Accounting Manager	Mr	Malone	Eliot		1-201-523-3725					eliot.malone@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	02/25/2021	2023	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5167	Automated TrOOP Balance Transfer Contact	HIMS Manager	Mr.	Madwell	Jason		1-719-314-2327				1-719-214-0149	jmadwell@rmhcare.org	2502 E. Pikes Peak Ave.,	Suite 100	Colorado Springs	CO	80909	01/06/2021	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	Best Available Evidence Contact	Chief Financial Officer	Mr.	Masar	Paul		1-719-466-8777	643			1-719-473-0628	pmasar@rmhcare.org	2502 E. Pikes Peak Ave.,	Suite 100	Colorado Springs	CO	80909	11/02/2020	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	Chief Financial Officer	Chief Financial Officer	Mr.	Masar	Paul		1-719-466-8777	643			1-719-314-8912	pmasar@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	11/02/2020	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	CMS Casework Communication Contact	VP Q&C	Ms.	Schlarb	Jacqueline		1-719-360-1864					jschlarb@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	05/17/2022	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	Coordination of Benefits Contact	Chief Financial Officer	Mr.	Masar	Paul		1-719-314-2327	643			1-719-314-0149	pmasar@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	01/05/2021	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	Customer Service Operations Contact	Vice President of PACE	Ms.	McDonough	Andi		1-719-466-8777	335				amcdonough@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	01/06/2021	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	Government Relations Contact	Chief Executive Officer	Mr.	Olson	Nate		1-719-466-8777	625				nolson@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	07/10/2020	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	Medicare Compliance Officer	VP Q&C	Ms.	Schlarb	Jacqueline		1-719-360-1864					jschlarb@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	05/17/2022	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	Part D Exceptions Contact	Chief Financial Officer	Mr.	Masar	Paul						1-719-314-0149	pmasar@rmhcare.org	2502 E Pikes Peak Ave		Colorado Springs	CO	80909	01/05/2021	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active	1-719-314-2327	643			PACE - Nat		C	Dallas
H5167	Pharmacy Network Management Contact	VP of Nursing	Ms.	VanMaldeghem	Santiana		1-719-466-8777				1-719-473-0628	svanmaldeghem@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	05/31/2022	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5167	Pharmacy Technical Help Desk Contact	VP of Nursing	Ms.	VanMaldeghem	Santiana						1-719-473-0628	svanmaldeghem@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	05/31/2022	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active	1-719-466-8777				PACE - Nat		C	Dallas
H5167	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Masar	Paul		1-719-314-2327	643			1-719-314-0149	pmasar@rmhcare.org	2502 E Pikes Peak Ave		Colorado Springs	CO	80909	01/05/2021	2023	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active					PACE - Nat		C	Dallas
H5178	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H5178	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H5178	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5190	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5190	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5190	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H5190	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5199	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/07/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H5199	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5199	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H5199	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5209	Automated TrOOP Balance Transfer Contact	A/R and Enrollment Manager	Ms.	Anton	Jean		1-608-245-3084				1-608-245-3895	antonj@carewisc.org	1617 Sherman Avenue		Madison	WI	53704	03/02/2018	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Best Available Evidence Contact	A/R and Enrollment Manager	Ms.	Anton	Jean		1-608-245-3084				1-608-245-3895	antonj@carewisc.org	1617 Sherman Avenue		Madison	WI	53704	03/02/2018	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Chief Financial Officer	Chief Financial Officer	Mr.	Hodson	James		1-414-287-7613					james.hodson@mychoicefamilycare.org	10201 Innovation Dr., Suite 100		Wauwatosa	WI	53226	01/06/2020	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	CMS Casework Communication Contact	Member Rights Manager	Ms.	Lord	Carmen		1-608-245-3448				1-608-245-3366	lordc@carewisc.org	1617 Sherman Avenue		Madison	WI	53704	03/02/2018	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Coordination of Benefits Contact	Claims Services Manager	Ms.	Roever	Deb		1-608-245-3804				1-608-245-3340	roeverd@carewisc.org	1617 Sherman Avenue		Madison	WI	53704	10/15/2018	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Customer Service Operations Contact	Customer Service Manager	Ms.	Fritz	Wendy		1-608-245-3476				1-608-246-8428	fritzw@carewisc.org	1617 Sherman Avenue		Madison	WI	53704	03/02/2018	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Government Relations Contact	Regulatory Affairs Manager	Ms.	Gardener	Dana		1-608-245-3486				1-608-246-8428	gardenerd@carewisc.org	1617 Sherman Avenue		Madison	WI	53704	08/27/2020	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Hospice Contact	Pharmacy Services Manager	Ms.	Holmes	Lani		1-608-245-3483				1-608-245-3096	Lani.Holmes@mychoicewi.org	1617 Sherman Ave.		Madison	WI	53704	06/24/2022	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Medicare Compliance Officer	Director of Regulatory Affairs	Ms.	Fahey	Emily		1-608-245-3573					emily.fahey@mychoicewi.org	1617 Sherman Ave		Madison	WI	53704	04/25/2022	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Part D Exceptions Contact	Pharmacy Services Manager	Ms.	Kveberg	Jean						1-608-245-3096	Jean.Kveberg@mychoicewi.org	1617 Sherman Avenue		Madison	WI	53704	06/24/2022	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active	1-800-963-0035	3037			HMO - Health Maintenance Organization		C	Chicago
H5209	Pharmacy Network Management Contact	Director Pharmacy Network Contracting		Dyer	Tim		1-330-888-4812				1-330-405-8094	tdyer@elixirsolutions.com	2181 East Aurora Rd., Suite 201		Twinsburg	OH	44087	02/11/2021	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5209	Pharmacy Technical Help Desk Contact	VP Operations		Conn	Todd							tconn@elixirsolutions.com	2181 East Aurora Rd., Suite 201		Twinsburg	OH	44087	02/11/2021	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active	1-844-550-6814				HMO - Health Maintenance Organization		C	Chicago
H5209	Plan to Plan Reconciliation Contact	A/R & Enrollment Manager	Ms.	Anton	Jean		1-608-245-3084				1-608-245-3895	antonj@carewisc.org	1617 Sherman Avenue		Madison	WI	53704	03/02/2018	2023	My Choice Wisconsin Health Plan, Inc.	Local CCP	My Choice Wisconsin Health Plan	HMO/HMOPOS		My Choice Wisconsin, Inc.	400	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5211	Automated TrOOP Balance Transfer Contact	Medicare Part D Coordinator		Hollatz	Lori		1-715-221-9814				1-715-221-9719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	09/06/2019	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Best Available Evidence Contact	Enrollment Services Team Lead		Ronning	Amy		1-715-221-9590				1-715-221-9500	ronning.amy@securityhealth.org	1515 Saint Joseph  Avenue		Marshfield	WI	54449	05/17/2021	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Chief Financial Officer	Vice President of Finance	Mr.	Buel	Chris		1-715-221-9555				1-715-221-9500	buel.chris@securityhealth.org	1001 North Oak Avenue		Marshfield	WI	54449	11/08/2022	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	CMS Casework Communication Contact	Director of Compliance and Privacy		Wilson	Kelly		1-715-221-9960				1-715-221-9500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	11/08/2022	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Coordination of Benefits Contact	Part D COB Specialist		Hollatz	Lori		1-715-221-9814				1-715-221-9500	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/20/2021	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Customer Service Operations Contact	Director of Member Experience & Contact Center		Baur	Ken		1-877-998-0998				1-715-221-9500	baur.ken@securityhealth.org	1515  Saint Joseph Avenue		Marshfield	WI	54449	12/31/2019	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Government Relations Contact	Director of Product Development		Howey	Kristina		1-715-221-5406				1-715-221-9500	howey.kristina@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	08/19/2022	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Hospice Contact	Interim PharmQuality Assurance-Auditing Specialist		Hollatz	Lori		1-715-221-9814				1-715-221-9500	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54440	01/14/2022	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Medicare Compliance Officer	Director of Compliance and Privacy	Mrs.	Wilson	Kelly		1-715-221-9960				1-715-221-9500	wilson.kelly@securityhealth.org	1515 Saint Joseph  Avenue		Marshfield	WI	54449	04/28/2022	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Part D Exceptions Contact	Clinical Pharmacy Services Manager		Meverden	Marc						1-715-221-9719	meverden.marc@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	11/06/2017	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	1-877-873-5611				HMO - Health Maintenance Organization		C	Denver
H5211	Pharmacy Network Management Contact	Clinical Pharmacy Services Manager		Meverden	Marc		1-715-221-9920				1-715-221-9719	meverden.marc@securityhealth.orgorg	1515 Saint Joseph Avenue		Marshfield	WI	54449	11/06/2017	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5211	Pharmacy Technical Help Desk Contact	Clinical Pharmacy Services Manager		Meverden	Marc						1-715-221-9719	meverden.marc@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	11/06/2017	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	1-877-873-5611				HMO - Health Maintenance Organization		C	Denver
H5211	Plan to Plan Reconciliation Contact	Vice President of Finance		Buel	Chris		1-715-221-9555				1-715-221-9500	buel.chris@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	11/08/2022	2023	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5212	Automated TrOOP Balance Transfer Contact			N/A (PACE)	N/A (PACE)		1-414-902-6044					michael.garlie@communitycareinc.org	N/A		Milwaukee	WI	53215	08/20/2008	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	Best Available Evidence Contact	Accounting Specialist - Medicare	Ms.	Instefjord	Lori		1-262-207-9374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	Chief Financial Officer	Chief Financial Officer	Ms.	Smith	Christy		1-414-231-4000					christy.smith@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/25/2017	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	CMS Casework Communication Contact	Chief Compliance & Quality Officer		Garlie	Michael		1-262-207-9307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	Coordination of Benefits Contact	Claims Manager	Ms.	Halloran	Colleen		1-262-953-8627					colleen.halloran@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	03/23/2015	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	Customer Service Operations Contact	Program Officer	Ms.	Carter	Kelly		1-262-207-9323					kelly.carter@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/22/2021	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	Government Relations Contact	Chief Executive Officer		Munson	Kenneth		1-262-207-9339					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookkfield	WI	53005	03/23/2015	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	Medicare Compliance Officer	Chief Compliance and Quality Officer	Mr	Garlie	Michael		1-262-207-9307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	Part D Exceptions Contact	Clinical  and Plan Services Pharmacy Manager	Mr.	Mayer	Dmitri							dmitri.mayer@communitycareinc.org	3220 W. Vliet		Milwaukee	WI	53208	06/22/2021	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active	1-866-992-6600	14107			PACE - Nat		C	Chicago
H5212	Pharmacy Network Management Contact	Clinical  and Plan Services Pharmacy Manager	Mr.	Mayer	Dmitri		1-414-231-4107					dmitri.mayer@communitycareinc.org	3220 W. Vliet		Milwaukee	WI	53208	06/22/2021	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5212	Pharmacy Technical Help Desk Contact			Service	Customer								2503 N. Hillcrest Parkway		Altoona	WI	54720-2569	03/08/2006	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active	1-888-298-7770				PACE - Nat		C	Chicago
H5212	Plan to Plan Reconciliation Contact	Accounting Specialist - Medicare	Ms	Instefjord	Lori		1-262-207-9374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2023	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	Chicago
H5213	Automated TrOOP Balance Transfer Contact	Director, PACE Finance		Hewitt	Jessica		1-720-974-6767				1-303-996-1600	jhewitt@myinnovage.com	8950 E. Lowry Blvd		Denver	CO	80230	09/16/2021	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-720-289-6171				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/16/2021	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	Chief Financial Officer	CFO	Mrs.	Gutierrez	Barbara		1-303-869-4664				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	03/14/2018	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-804-543-0876				1-303-996-1600	epeak@myinnovage.com	8950 E Lowry Blvd		Denver	CO	80230	10/01/2021	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/27/2020	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	Customer Service Operations Contact	Regional Executive Director		Williams	Jeanette		1-909-677-9517				1-303-996-1600	JWilliams3@myinnovage.com	8950 E Lowry Blvd		Denver	CO	80230	04/26/2022	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	Government Relations Contact	Executive VP Government Relations		Steckel	Carol		1-720-789-6157				1-303-996-1600	CSteckel@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/26/2022	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	Medicare Compliance Officer	VP of Pharmacy Services	Mrs.	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/24/2020	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	Part D Exceptions Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/24/2020	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	1-303-869-4664				PACE - Nat		C	Denver
H5213	Pharmacy Network Management Contact	VP of Pharmacy Services	Mrs.	Chase	Darla		1-303-869-4664				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/24/2020	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5213	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Mrs	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 E Lowry Boulevard		Denver	CO	80230	04/24/2020	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Denver
H5213	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-720-974-6031				1-720-917-3390	AKizewski@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	09/16/2021	2023	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Denver
H5215	Automated TrOOP Balance Transfer Contact	Vice President - Pharmacy	Mr	Regalia	Ted		1-920-720-1654				1-920-720-1906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	12/23/2020	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Best Available Evidence Contact	Director, Operations		Techlin	Cara		1-920-720-1502				1-920-720-1931	ctechlin@networkhealth.com	1570 Midway Place		Menasha	WI	54952	12/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Chief Financial Officer	Chief Financial Officere	Mr	Ollech	Brian		1-920-720-1886					bollech@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	08/22/2017	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	CMS Casework Communication Contact	Director, Regulatory Affairs		Schuster	Shannon		1-920-628-7267					sschuste@networkhealth.com	1570 Midway Place		Menasha	WI	54952	12/17/2021	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Coordination of Benefits Contact	Director - Pharmacy		Wheaton	Andy		1-920-720-1612				1-920-720-1906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/18/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Customer Service Operations Contact	Manager, Customer Service		Schwandner	Stacy		1-920-720-1309				1-920-720-1908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	07/27/2018	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Government Relations Contact	Compliance Officer		Keenan	Angela		1-920-720-1242					nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/13/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Hospice Contact	Pharmacy Lead		Kempfer	Amanda		1-920-720-1607					pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/09/2018	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Medicare Compliance Officer	Compliance Officer	Mrs.	Keenan	Angela		1-920-720-1242				1-920-720-1912	nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/13/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Part D Exceptions Contact	Director, Provider Integration		Delebreau	Jennifer						1-920-720-1908	jdelebre@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active	1-800-378-5234				PPO - BBA		C	Chicago
H5215	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/15/2013	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5215	Pharmacy Technical Help Desk Contact	Director - Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy STE 150		Temple Terrace	FL	33637	12/17/2021	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H5215	Plan to Plan Reconciliation Contact	Vice President - Finance		Leigh	Dennis		1-920-720-1837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	01/04/2021	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Chicago
H5216	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H5216	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H5216	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5232	Automated TrOOP Balance Transfer Contact	Analyst	Mr.	Klatt	Donni		1-419-887-2940				1-419-887-2020	Donni.Klatt@ProMedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Best Available Evidence Contact	Analyst	Mr.	Klatt	Donni		1-419-887-2917				1-419-887-2040	Donni.Klatt@ProMedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Chief Financial Officer	Chief Financial Officer	Mr.	Martin	Jeff		1-419-887-2959				1-419-887-2031	jeff.martin@promedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	CMS Casework Communication Contact	Member Services Team Leader	Ms.	Harper	Leslie		1-419-887-2410				1-419-887-2047	leslie.harper@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Coordination of Benefits Contact	Director Risk Adjustment & Recoveries	Ms.	Curry	Deborah		1-419-887-2215				1-419-887-2398	Deborah.Curry@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Customer Service Operations Contact	Operations Manager, Member Services	Ms.	Trivedi	Kyle		1-419-887-2424				1-419-887-2047	kyle.trivedi@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Government Relations Contact	Manager, Regulatory Affairs	Ms.	Beadle	Nicole		1-419-887-2859				1-419-887-2011	nicole.beadle@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Hospice Contact	Pharmacy Regulatory Compliance Coordinator	Mr.	Ingman	Brian		1-419-887-2204				1-567-585-9454	Brian.Ingman@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	12/28/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Medicare Compliance Officer	Manager, Regulatory Affairs	Ms.	Beadle	Nicole		1-419-887-2859				1-419-887-2011	nicole.beadle@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Exceptions Contact	Senior Pharmacist	Mr.	Bogner	Craig	M					1-567-585-9454	craig.bogner@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active	1-800-462-3589				PPO - BBA		C	Chicago
H5232	Pharmacy Network Management Contact	Senior Pharmacist	Mr.	Bogner	Craig	M	1-419-887-2249				1-567-585-9454	craig.bogner@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5232	Pharmacy Technical Help Desk Contact	Manager, Vendor Management	Mr.	Palmieri	Mike							Mike.Palmieri@Caremark.com	2401 Cherahala Blvd		Knoxville	TN	37932	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active	1-866-693-4620				PPO - BBA		C	Chicago
H5232	Plan to Plan Reconciliation Contact	Sr. Analyst	Mr.	Elliott	Sean		1-419-887-2922				1-419-887-2020	Sean.Elliott@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	Local PPO		Promedica Health System, Inc.	191	Yes	Active					PPO - BBA		C	Chicago
H5253	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H5253	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5253	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H5253	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5256	Chief Financial Officer	Director of Finance	Ms.	Mitchell	Jill		1-563-556-8070	4831			1-563-556-5134	jmitchell@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	01/03/2023	2023	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	1876 Cost	Medical Associates Clinic Health Plan of Wisconsin	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H5256	CMS Casework Communication Contact	Medicare Compliance Analyst		Digmann	Jodi	A	1-563-584-4836				1-563-556-5134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	02/11/2022	2023	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	1876 Cost	Medical Associates Clinic Health Plan of Wisconsin	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H5256	Customer Service Operations Contact	Member Services Supervisor		Boge	Laura		1-569-556-8070	4857			1-569-556-5134	lboge@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	05/20/2021	2023	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	1876 Cost	Medical Associates Clinic Health Plan of Wisconsin	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H5256	Government Relations Contact	Medicare Compliance Analyst		Digmann	Jodi	A	1-563-584-4836				1-563-556-5134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	02/11/2022	2023	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	1876 Cost	Medical Associates Clinic Health Plan of Wisconsin	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H5256	Medicare Compliance Officer	Director of Operations	Ms.	Hoffmann	Karen		1-563-556-8070	4817			1-563-556-5134	khoffman@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	05/20/2021	2023	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	1876 Cost	Medical Associates Clinic Health Plan of Wisconsin	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Kansas City
H5262	Automated TrOOP Balance Transfer Contact	Pharmacy Manager		Suhr	Anessa		1-608-881-8616				1-608-881-8307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Best Available Evidence Contact	Director of Enrollment		Krueger	Cindy		1-608-471-4900					cindy.krueger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Chief Financial Officer	Vice President, CFO, Treasurer	Mr.	Hiveley	Jim		1-608-821-1081					james.hiveley@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	CMS Casework Communication Contact	Compliance Analyst		Stanton	Jessica		1-608-881-8157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Coordination of Benefits Contact	Director of Enrollment		Krueger	Cindy		1-608-471-4900					cindy.krueger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Customer Service Operations Contact	Senior Director of Customer Success		Greubel	Lori		1-608-644-1433					lori.greubel@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Government Relations Contact	Assistant Vice President Compliance & Government	Mrs.	Skifton	Kelly		1-608-881-8151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Hospice Contact	Pharmacy Manager		Suhr	Anessa		1-608-881-8616				1-608-881-8307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Medicare Compliance Officer	Assistant Vice President Compliance & Government	Ms.	Skifton	Kelly	N	1-608-881-8151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Exceptions Contact	Pharmacy Manager		Suhr	Anessa						1-608-881-8307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	1-800-394-5566				HMO - Health Maintenance Organization		C	Chicago
H5262	Pharmacy Network Management Contact	Pharmacy Manager		Suhr	Anessa		1-608-881-8616				1-608-881-8307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Pharmacy Technical Help Desk Contact	Quartz Medicare Advantage Part D Help Desk		Medicare Advantage	Quartz							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	1-888-728-4689				HMO - Health Maintenance Organization		C	Chicago
H5262	Plan to Plan Reconciliation Contact	Accountant		Cheung	Sheila		1-608-881-8082					sheila.cheung@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5264	Chief Financial Officer	Chief Financial Officer	Mr	Ruplinger	Randy		1-608-827-4030					hpmscfo.inbox@deancare.com	1277 Deming Way		Madison	WI	53717	06/15/2017	2023	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Chicago
H5264	CMS Casework Communication Contact	Director of Claims Operations & Customer Relations		Genin	William	J	1-608-827-4486					William.Genin@deancare.com	1277 Deming Way		Madison	WI	53717	07/05/2013	2023	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Chicago
H5264	Customer Service Operations Contact	Director of Claims Operations  Customer Relations		Genin	William	J	1-608-827-4486					William.Genin@deancare.com	1277 Deming Way		Madison	WI	53717	07/05/2013	2023	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Chicago
H5264	Government Relations Contact	General Counsel, Director of Legal Services		Sutton	Dean		1-608-827-4301					dean.sutton@deancare.com	1277 Deming Way		Madison	WI	53717	02/16/2017	2023	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Chicago
H5264	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Specht	Jacob		1-608-827-4209					Jacob.Specht@deancare.com	1277 Deming Way		Madison	WI	53717	03/01/2022	2023	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Chicago
H5273	Automated TrOOP Balance Transfer Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Best Available Evidence Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Chief Financial Officer	SVP Chief Financial Officer	Mr.	Kurpad	Umesh		1-781-612-1000	84968				umesh.kurpad@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	CMS Casework Communication Contact	Director, Appeals & Grievances	Ms.	Evans	Kathleen		1-617-972-9400	87204				kathleen.evans@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Coordination of Benefits Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Customer Service Operations Contact	Manager, Member Services	Ms.	Villatoro	Yesly		1-781-612-1000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Government Relations Contact	Chief Government Affairs Officer	Ms.	Lewis	Kristin		1-781-612-1000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Hospice Contact	Manager, Pharmacy Operations & Programs	Ms.	MacAuley	Jacqueline		1-781-612-1000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Taylor	James		1-781-612-1000	88089				james.taylor@point32health.org	1 Wellness Way		Canton	MA	02021	01/04/2023	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-781-612-1000	82370			HMO - Health Maintenance Organization		C	Boston
H5273	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/09/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	12/08/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-855-524-0380				HMO - Health Maintenance Organization		C	Boston
H5273	Plan to Plan Reconciliation Contact	Manager, Finance Operations	Ms.	Olson	Rachel		1-781-612-1000	84360				rachel.olson@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5280	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Government Relations Contact	MHO- Vice President, Government Contracts		Saelens	Holly		1-614-547-6818					holly.saelens@molinahealthcare.com	300 Corporate Exchange		Columbus	OH	43231	07/06/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				Demo Risk Option C	MMP HMO Demo	C	Chicago
H5280	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Demo	Molina Healthcare of Ohio	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H5292	Automated TrOOP Balance Transfer Contact	VP of IT		Ramaglia	Damon		1-347-842-3584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	Best Available Evidence Contact	VP of Operational Support		Rosen	Richard		1-347-842-3684					richard.rosen@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	Chief Financial Officer	SVP of Finance	Mr.	Cavaliere	Andrew		1-347-842-3505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	CMS Casework Communication Contact	Executive Vice President	Ms.	Aldrich	Susan		1-914-960-4407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	Coordination of Benefits Contact	SVP of Finance	Mr.	Cavaliere	Andrew		1-347-842-3505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	Customer Service Operations Contact	VP of Member Services		Hron	Patty		1-347-842-3541					patty.hron@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	Government Relations Contact	Executive Vice President	Ms.	Aldrich	Susan		1-914-960-4407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	Medicare Compliance Officer	SVP, Regulatory Affairs	Ms.	Ling	Jenny		1-347-842-3528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	Part D Exceptions Contact	Director of Medicare		Williams	Sadirah							Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending	1-201-832-0060				PACE - Nat		C	New York
H5292	Pharmacy Network Management Contact	Director of Medicare		Williams	Sadirah		1-201-832-0060					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5292	Pharmacy Technical Help Desk Contact	Director of Medicare		Williams	Sadirah							Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending	1-201-832-0060				PACE - Nat		C	New York
H5292	Plan to Plan Reconciliation Contact	AVP of Finance		Lugo	Michelle		1-347-842-3557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2023	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE				Yes	Pending					PACE - Nat		C	New York
H5294	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5294	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5294	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H5294	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5296	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	08/25/2020	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	San Francisco
H5296	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5296	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/21/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				HMO - Health Maintenance Organization		C	San Francisco
H5296	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	02/07/2020	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5299	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H5299	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5299	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H5299	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5302	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H5302	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5302	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H5302	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5322	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H5322	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5322	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H5322	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5325	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-888-736-9118				1-888-554-7668	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/03/2018	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H5325	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5325	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H5325	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5342	Automated TrOOP Balance Transfer Contact			Carrothers	Michelle		1-309-655-2850					Michelle.A.Carrothers@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	Best Available Evidence Contact			Bentler-Lampe	Lois		1-309-655-2850					Lois.M.BentlerLampe@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	Chief Financial Officer		Mr.	Allen	Michael		1-309-655-2850					Michael.M.Allen@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	CMS Casework Communication Contact			Pritzker	Nathan		1-309-655-2850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	Coordination of Benefits Contact			Pritzker	Nathan		1-309-655-2850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	Customer Service Operations Contact			Pritzker	Nathan		1-309-655-2850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	Government Relations Contact			Manson	Chris		1-309-655-2850					Christopher.M.Manson@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	Medicare Compliance Officer		Mr.	Tonozzi	Clinton		1-309-655-2850					Clinton.J.Tonozzi@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	Part D Exceptions Contact			Storm	Jerry							Jerry.A.Storm@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending	1-309-655-2850				PACE - Nat		C	Chicago
H5342	Pharmacy Network Management Contact			Storm	Jerry		1-309-655-2850					Jerry.A.Storm@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5342	Pharmacy Technical Help Desk Contact			Storm	Jerry								124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending	1-309-655-2850				PACE - Nat		C	Chicago
H5342	Plan to Plan Reconciliation Contact			Pritzker	Nathan		1-309-655-2850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/19/2022	2023	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare System PACE	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5372	Automated TrOOP Balance Transfer Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Best Available Evidence Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Chief Financial Officer	Chief Financial Officer	Mr.	Grabski	Ben		1-763-300-7611					bgrabski@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	CMS Casework Communication Contact	Sr. Director Compliance	Mr.	Whitbeck	Britton		1-314-209-3989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Coordination of Benefits Contact			Inquiries	COB		1-855-425-0457					COBInquiry@lumeris.com	P O BOX 5907		TROY	MI	48007	12/06/2022	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoffer	Linda		1-636-686-9682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		1-314-209-2717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Hospice Contact	Director, Pharmacy		Cruz	Jennifer		1-314-770-3556					pharmacy@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Medicare Compliance Officer	VP Internal Audit and Chief Compliance Officer	Ms.	Venable	Erin		1-314-209-3957					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Part D Exceptions Contact		Ms.	Byers	June							June.Byers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				HMO - Health Maintenance Organization		C	Kansas City
H5372	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5372	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				HMO - Health Maintenance Organization		C	Kansas City
H5372	Plan to Plan Reconciliation Contact	Manager, Client Payments		Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5373	Automated TrOOP Balance Transfer Contact	Analyst	Mr.	Klatt	Donni		1-419-887-2940				1-419-887-2020	Donni.Klatt@ProMedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Best Available Evidence Contact	Analyst	Mr.	Klatt	Donni		1-419-887-2917				1-419-887-2040	Donni.Klatt@ProMedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Chief Financial Officer	Chief Financial Officer	Mr.	Martin	Jeff		1-419-887-2959				1-419-887-2031	jeff.martin@promedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	CMS Casework Communication Contact	Member Services Team Leader	Ms.	Harper	Leslie		1-419-887-2410				1-419-887-2047	leslie.harper@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Coordination of Benefits Contact	Director Risk Adjustment & Recoveries	Ms.	Curry	Deborah		1-419-887-2215				1-419-887-2398	Deborah.Curry@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Customer Service Operations Contact	Operations Manager, Member Services	Ms.	Trivedi	Kyle		1-419-887-2424				1-419-887-2047	kyle.trivedi@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Government Relations Contact	Manager, Regulatory Affairs	Ms.	Beadle	Nicole		1-419-887-2859				1-419-887-2011	nicole.beadle@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Hospice Contact	Pharmacy Regulatory Compliance Coordinator	Mr.	Ingman	Brian		1-419-887-2204				1-567-585-9454	Brian.Ingman@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	12/28/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Medicare Compliance Officer	Manager, Regulatory Affairs	Ms.	Beadle	Nicole		1-419-887-2859				1-419-887-2011	nicole.beadle@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Part D Exceptions Contact	Senior Pharmacist	Mr.	Bogner	Craig	M					1-567-585-9454	craig.bogner@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active	1-800-462-3589				HMO - Health Maintenance Organization		C	Chicago
H5373	Pharmacy Network Management Contact	Senior Pharmacist	Mr.	Bogner	Craig	M	1-419-887-2249				1-567-585-9454	craig.bogner@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5373	Pharmacy Technical Help Desk Contact	Manager, Vendor Management	Mr.	Palmieri	Mike							Mike.Palmieri@Caremark.com	2401 Cherahala Blvd		Knoxville	TN	37932	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H5373	Plan to Plan Reconciliation Contact	Sr. Analyst	Mr.	Elliott	Sean		1-419-887-2922				1-419-887-2020	Sean.Elliott@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT CARE OF INDIANA, INC.	Local CCP	ProMedica Medicare Plan	HMO/HMOPOS		Promedica Health System, Inc.	191	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5374	Automated TrOOP Balance Transfer Contact			Rush	Jamie		1-561-690-1134					ESITroopTransfer@express-scripts.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Best Available Evidence Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N 107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Chief Financial Officer		Mr.	Granow	Les		1-561-444-0709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	CMS Casework Communication Contact			Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Coordination of Benefits Contact		Ms.	Burdelik	Dawn		1-561-815-3729					dawn.burdelik@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Customer Service Operations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Government Relations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Hospice Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Medicare Compliance Officer		Ms.	Lacey	Jennifer		1-813-367-7169					Jennifer.lacey@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						1-888-235-8551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-204-0016				HMO - Health Maintenance Organization		C	New York
H5374	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		1-800-204-0016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5374	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						1-888-235-8551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H5374	Plan to Plan Reconciliation Contact		Ms.	Zhai	Vicky		1-561-632-8915					Vicky.Zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5377	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H5377	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H5377	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5386	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		1-858-499-5358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Best Available Evidence Contact	EDI Management Supervisor		Guglielmetti	Brett		1-858-499-8108					Brett.Guglielmetti@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	92123-1450	10/06/2016	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Chief Financial Officer	Vice President and Chief Financial Officer	Ms.	Datko	Rita		1-858-499-8391					Rita.Datko@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	92123-1450	06/01/2016	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	CMS Casework Communication Contact	Supervisor, Appeals and Grievances		Randolph	Takeisha		1-858-499-8058					TAKEISHA.RANDOLPH@SHARP.COM	8520 Tech Way	Suite 201	San Diego	CA	92123-1450	12/31/2018	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Coordination of Benefits Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		1-858-499-5358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Customer Service Operations Contact	Manager, Customer Care		Meredith	Olivia		1-858-499-8019					olivia.meredith@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	92123-1450	12/19/2019	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Government Relations Contact	Dir Compliance/Reg Affairs		Mooney	Ryan		1-858-499-8237					ryan.mooney@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	92123-1450	07/08/2022	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Hospice Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		1-858-499-5358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Pels-Beck	Leslie		1-858-499-8327					Leslie.Pels-Beck@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	92123-1450	05/26/2017	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Part D Exceptions Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary							zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	06/24/2020	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active	1-855-562-8853				HMO - Health Maintenance Organization		C	San Francisco
H5386	Pharmacy Network Management Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		1-858-499-5358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5386	Pharmacy Technical Help Desk Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary							zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	06/24/2020	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	San Francisco
H5386	Plan to Plan Reconciliation Contact	Manager, Accounting and Finance		Lee	Summer		1-858-499-8203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	92123-1450	01/30/2018	2023	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5398	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5398	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5398	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H5398	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5403	Automated TrOOP Balance Transfer Contact	Health Plan Manager		Li	Jiewen		1-415-292-8692				1-415-292-8745	jiewenl@onlok.org	1333 Bush Street		San Francisco	CA	94109	12/16/2019	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Best Available Evidence Contact	Senior Software Architect		Lin	Alan		1-628-208-8442				1-415-292-8745	alan@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/23/2018	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Chief Financial Officer	Interim Chief Financial Officer	Mr.	Gerlach	Carl		1-628-208-8477				1-415-292-8745	carl.gerlach@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/06/2022	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	CMS Casework Communication Contact	Health Plan Manager		Li	Jiewen		1-415-292-8692				1-415-292-8745	jiewenl@onlok.org	1333 Bush Street		San Francisco	CA	94109	12/16/2019	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Coordination of Benefits Contact	Interim Chief Financial Officer		Gerlach	Carl		1-628-208-8477				1-415-292-8745	carl.gerlach@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/06/2022	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Customer Service Operations Contact	Chief of Government Affairs and Compliance		Kunz	Eileen		1-415-292-8722				1-415-292-8745	ekunz@onlok.org	1333 Bush Street		San Francisco	CA	94109	01/16/2015	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Government Relations Contact	Chief of Government Affairs and Compliance		Kunz	Eileen		1-415-292-8722				1-415-292-8745	ekunz@onlok.org	1333 Bush Street		San Francisco	CA	94109	01/16/2015	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Medicare Compliance Officer	Chief of Government Affairs and Compliance	Ms.	Kunz	Eileen		1-415-292-8722				1-415-292-8745	ekunz@onlok.org	1333 Bush Street		San Francisco	CA	94109	01/16/2015	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Part D Exceptions Contact	Chief Medical Officer	Dr.	Lui	Benjamin						1-415-292-8745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active	1-888-996-6565				PACE - Nat		C	San Francisco
H5403	Pharmacy Network Management Contact	Chief Medical Officer	Dr.	Lui	Benjamin		1-415-292-2882				1-415-292-8745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Pharmacy Technical Help Desk Contact	Chief Medical Officer	Dr.	Lui	Benjamin						1-415-292-8745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active	1-888-996-6565				PACE - Nat		C	San Francisco
H5403	Plan to Plan Reconciliation Contact	Director of Regulatory Affairs and Compliance		Chau	Jonathan		1-415-292-8852				1-415-292-8745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	01/09/2017	2023	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5405	Automated TrOOP Balance Transfer Contact	CFO	Ms.	Holden	Laura		1-510-433-1150	7140			1-510-452-8836	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	08/25/2021	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	Best Available Evidence Contact	CMO	Dr.	Mittelberger	James		1-510-433-1150	7117			1-510-452-8836	JMittelberger@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/03/2021	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	Chief Financial Officer	CFO	Ms.	Holden	Laura		1-510-433-1150	7140			1-510-452-8836	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	08/25/2021	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	CMS Casework Communication Contact	Compliance Director		Ceruzzi	Alice		1-510-433-1150	7138			1-510-452-8836	ACeruzzi@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	11/30/2022	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	Coordination of Benefits Contact	CFO	Ms.	Holden	Laura		1-510-433-1150	7140			1-510-452-8836	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	08/25/2021	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	Customer Service Operations Contact	CEO	Ms.	Zamora	Maria		1-510-452-8812				1-510-452-8836	mzamora@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/09/2021	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	Government Relations Contact	CEO	Ms.	Zamora	Maria		1-510-452-8812				1-510-452-8836	mzamora@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/09/2021	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	Medicare Compliance Officer	Director, Compliance	Ms.	Ceruzzi	Alice		1-510-433-1150	7138				ACeruzzi@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	11/30/2022	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	Part D Exceptions Contact	Financial Analyst	Mr.	Moon	Geoff						1-510-844-0189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	07/10/2012	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active	1-510-433-1160	7158			PACE - Nat		C	San Francisco
H5405	Pharmacy Network Management Contact	Financial Analyst	Mr.	Moon	Geoff		1-510-433-1160	7158			1-510-844-0189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5405	Pharmacy Technical Help Desk Contact	Financial Analyst	Mr.	Moon	Geoff						1-510-844-0189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active	1-510-433-1160	7158			PACE - Nat		C	San Francisco
H5405	Plan to Plan Reconciliation Contact	CFO	Ms.	Holden	Laura		1-510-433-1150	7140			1-510-452-8836	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	08/25/2021	2023	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active					PACE - Nat		C	San Francisco
H5406	Automated TrOOP Balance Transfer Contact	Finance Manager	Mr.	Salas	Rafael		1-916-491-3415				1-916-491-6408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/22/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Best Available Evidence Contact	Executive Director	Ms.	Erdmann	Julie	A	1-833-560-7223				1-916-491-3408	Julie.Erdmann@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	11/08/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Chief Financial Officer	Finance Manager	Mr.	Salas	Rafael		1-916-491-3415				1-916-491-6408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	CMS Casework Communication Contact	Executive Director	Ms.	Erdmann	Julie	A	1-833-560-7223				1-916-491-3408	Julie.Erdmann@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	11/08/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Coordination of Benefits Contact	Finance Manager	Mr.	Salas	Rafael		1-916-491-3415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Customer Service Operations Contact	Executive Director	Ms.	Erdmann	Julie	A	1-833-560-7223				1-916-491-3408	Julie.Erdmann@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	11/08/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Government Relations Contact	Executive Director	Ms.	Erdmann	Julie	A	1-833-560-7223				1-916-491-3408	Julie.Erdmann@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	11/08/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Medicare Compliance Officer	Compliance Officer	Ms.	Yau	Allison	Y	1-530-301-1499					Allison.Yau@sutterhealth.org	2880 Gateway Oaks Dr	Sutter Health Office of General Counsel,  Ethics & Comp	Sacramento	CA	95833	11/08/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Part D Exceptions Contact	Finance Manager	Mr.	Salas	Rafael						1-916-491-6408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active	1-833-560-7223				PACE - Nat		C	San Francisco
H5406	Pharmacy Network Management Contact	Finance Manager	Mr.	Salas	Rafael		1-916-491-3415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Pharmacy Technical Help Desk Contact	Project & Technical Services Coordinator	Ms.	Burgess	Jewel						1-916-491-3484	burgesjr@sutterhealth.org	444 North 3rd Street	Ste 150	Sacramento	CA	95811	05/18/2021	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active	1-833-560-7223				PACE - Nat		C	San Francisco
H5406	Plan to Plan Reconciliation Contact	Finance Manager	Mr.	Salas	Rafael		1-916-491-3415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2023	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5410	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/20/2020	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H5410	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H5410	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	HEALTHSPRING OF FLORIDA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5420	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H5420	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5420	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H5420	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5422	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H5422	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5422	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H5422	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations and Formulary		Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Best Available Evidence Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		1-562-637-1234				1-562-989-5243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/28/2019	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Chief Financial Officer	Chief Financial Officer	Mr	Plumb	Michael		1-562-997-1589					MPlumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/02/2020	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	CMS Casework Communication Contact	Director, Reg Audit & Ent Mntrng		Cordova	Elizabeth		1-562-997-3131	3131			1-562-989-5120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/18/2022	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Coordination of Benefits Contact	Director, Pharmacy Operations and Formulary	Ms.	Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/03/2022	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		1-562-997-1805				1-562-989-5181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/27/2014	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Government Relations Contact	Sr. Vice President, Public & Government Affairs		Morrell	Adrienne		1-202-349-9008				1-562-989-9439	amorrell@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/12/2019	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Hospice Contact	Manager, Pharmacy Experience & Access	Mr.	Tran	Tri		1-562-308-2884				1-562-997-3196	TMTran@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	02/09/2022	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Medicare Compliance Officer	Compliance Officer	Ms.	Hawkins	Ginette		1-562-308-1195					GHawkins@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/23/2019	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Part D Exceptions Contact	Senior Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	San Francisco
H5425	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/13/2018	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5425	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy	STE 150	Temple Terrace	FL	33637	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	San Francisco
H5425	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		1-562-989-8300				1-562-989-0101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/09/2019	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5427	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		1-813-506-6000	66072				PartD@freedomh.com	4200 W Cypress St	Suite 800	Tampa	FL	33607	03/01/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Best Available Evidence Contact	Vice President, Enrollment		Conner	Claudius		1-813-459-8739				1-813-506-6151	CMSEnrollment@freedomh.com	4200 W. Cypress Street		Tampa	FL	33607	03/01/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Chief Financial Officer	CFO	Ms	Newman	Elena		1-305-342-0885					cms@freedomh.com	9250 W Flagler St		Miami	FL	33174	06/28/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	CMS Casework Communication Contact	Compliance Officer		Kortsch	Diane		1-414-336-9395				1-813-506-6151	cms@freedomh.com	4200 Cypress St	Suite 800	Tampa	FL	33607	03/01/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Coordination of Benefits Contact	VP of Finance	Mr	Caruso	David		1-813-506-6000	11006			1-813-506-6151	CMSFinance@freedomh.com	4200 Cypress Street	Suite 800	Tampa	FL	33607	03/01/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Customer Service Operations Contact	Director of Member Services		Doroteo	Carlos		1-813-506-6000	11342			1-813-506-6150	CMSMemberServices@freedomh.com	4200 Cypress Street	Suite 800	Tampa	FL	33607	03/01/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Government Relations Contact	Compliance Officer	Ms	Kortsch	Diane		1-414-336-9395					cms@freedomh.com	4200 Cypress St	Suite 800	Tampa	FL	33607	03/01/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Hospice Contact	Pharmacist		Marrocco	Brianna		1-727-451-6800	66072			1-813-506-6152	PartD@freedomh.com	2240 Belleair Road	Suite 250	Clearwater	FL	33764	03/01/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Medicare Compliance Officer	Compliance Officer	Ms	Kortsch	Diane		1-414-336-9395				1-813-506-6151	CMSAccounting@freedomh.com	4200 Cypress St	Suite 800	Tampa	FL	33607	11/04/2021	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Part D Exceptions Contact	Pharmacist		Marrocco	Brianna						1-813-506-6152	bmarrocco@freedomh.com	2240 Belleair Rd Ste 250		Clearwater	FL	33762	01/08/2020	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-727-451-6800	66072			HMO - Health Maintenance Organization		C	Chicago
H5427	Pharmacy Network Management Contact	Director Of Operations-PR		Goluch	Adrian		1-813-506-6000	11354			1-813-506-6152	agoluch@freedomh.com	4200 Cypress Street	Suite 800	Tampa	FL	33607	03/01/2022	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Pharmacy Technical Help Desk Contact	VP Rx Retail Network / Contracting IngenioRx Presi		Gettings	Darren							darren.gettings@Ingenio-RX.com	1831 Chestnut St		St Louis	MO	63103	01/02/2020	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4267				HMO - Health Maintenance Organization		C	Chicago
H5427	Plan to Plan Reconciliation Contact	P2P Contact		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd	Ste 100 Mailstop CA9304-R04H	Woodland Hills	CA	91367	06/14/2021	2023	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5430	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/03/2021	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/07/2022	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Government Relations Contact	Vice President, Complex Care Products	Ms.	Arden	Gale		1-314-725-4477	47759				garden@centene.com	7700 Forsyth Blvd		St. Louis	MO	63105	04/01/2021	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5430	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5430	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H5430	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	ONE CARE BY CARE1ST HEALTH PLAN OF ARIZONA, INC.	Local CCP	WellCare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5431	Automated TrOOP Balance Transfer Contact	Data Analyst	Mr.	Roberts	Jerryon		1-305-234-9292	250				Jerryon_Roberts@Health-Sun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	12/09/2021	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Best Available Evidence Contact	Staff VP Ops & Systems Solns	Ms.	Newman	Elena		1-305-921-2623				1-305-460-3907	HSComplianceMailbox@healthsun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	03/24/2022	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	09/02/2021	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	CMS Casework Communication Contact	Director I, Compliance	Mrs.	Abreu	Inez	B	1-786-449-4677				1-305-444-9148	HSComplianceMailbox@healthsun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	01/10/2022	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Coordination of Benefits Contact	Payment Integrity Manager, Claims	Ms.	Tortora	Idany		1-305-448-8100	262			1-305-444-9148	HSComplianceMailbox@healthsun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	01/10/2022	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Customer Service Operations Contact	Member Services Manager	Ms.	Gallardo	Viviana		1-305-448-8100	559			1-305-444-9148	cms_memberservices@healthsun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	12/10/2021	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Government Relations Contact	Director II Compliance	Mrs.	Troutman	Crysten		1-813-486-4656					HSComplianceMailbox@healthsun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	08/09/2022	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Hospice Contact	Director Clinical Programs		Martinez	Massiel		1-305-448-8100	353				cms_partd@healthsun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	12/10/2021	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Medicare Compliance Officer	VP, Compliance	Ms.	Turano	Michelle		1-813-830-6984					MedicareCO@anthem.com	4200 W. Cypress Street		Tampa	FL	33607	02/04/2019	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Part D Exceptions Contact	Appeals and Grievances Manager		Anda	Diana							cms_memberservices@healthsun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	12/10/2021	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-877-336-2069				HMO - Health Maintenance Organization		C	Chicago
H5431	Pharmacy Network Management Contact	Director Clinical Programs		Martinez	Massiel		1-305-448-8100	353				cms_partd@healthsun.com	9250 W. Flagler Street	Suite 600	Miami	FL	33174	12/10/2021	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Pharmacy Technical Help Desk Contact	VP Rx Retail	Mr.	Gettings	Darren							darren.gettings@Ingenio-RX.com	1831 Chestnut Street		St. Louis	MO	63103	01/02/2020	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H5431	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	06/14/2021	2023	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5433	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		1-858-790-6250				1-858-790-6052	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Best Available Evidence Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		1-657-235-6994					aphillips@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Chief Financial Officer	Chief Financial Officer	Ms.	Huang	Nancy		1-657-235-6935					nhuang@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	CMS Casework Communication Contact	Director, Clinical Pharmacy Management		Gericke	Kristin		1-714-246-8471				1-714-246-8649	kgericke@caloptima.org	CalOptima	505 City Parkway West	Orange	CA	92868	02/22/2013	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Coordination of Benefits Contact			Cardenas	Albert		1-714-246-8878					COBinquiries@caloptima.org	505 City Parkway West		Orange	CA	92868	04/21/2022	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Customer Service Operations Contact	Interim Executive Director, Operations	Ms.	Khamseh	Ladan		1-714-246-8866					lkhamseh@caloptima.org	505 City Parkway West		Orange	CA	92868	09/16/2021	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Government Relations Contact	Manager		Gomez	Gisela		1-714-246-8757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Hospice Contact	Director, Clinical Pharmacy Management		Gericke	Kris		1-714-246-8460					kgericke@caloptima.org	505 City Parkway West		Orange	CA	92868	04/30/2020	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Medicare Compliance Officer	Director of Regulatory Affairs and Compliance, Med	Ms.	Phillips	Annie		1-657-235-6994					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	07/21/2022	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Part D Exceptions Contact	Director, Clinical Pharmacy Management		Gericke	Kristin						1-714-246-8649	kgericke@caloptima.org	CalOptima	505 City Parkway West	Orange	CA	92868	02/22/2013	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active	1-877-412-2734				HMO - Health Maintenance Organization		C	San Francisco
H5433	Pharmacy Network Management Contact	Manager, PNS & Claims Operations		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/28/2015	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5433	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/24/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active	1-800-819-5532				HMO - Health Maintenance Organization		C	San Francisco
H5433	Plan to Plan Reconciliation Contact	Controller	Mr.	Kaing	Jason		1-657-900-1373					p2p@caloptima.org	505 City Parkway West		Orange	CA	92868	04/30/2020	2023	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5434	Automated TrOOP Balance Transfer Contact	Manager, PBM operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/27/2020	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Best Available Evidence Contact	Sr. Director EMB		Chick	Benjamin		1-904-905-1711					benjamin.chick@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/24/2022	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Chief Financial Officer	SVP and CFO	Mr.	Justice	Thurman		1-904-905-5085					Thurman.Justice@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 8th Floor	Jacksonville	FL	32246	08/21/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	CMS Casework Communication Contact	Sr Manager Business Support		Stewart	Delores		1-904-905-0558					Delores.Stewart@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	07/17/2020	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Coordination of Benefits Contact	Manager PBM Operations		Hanson	Michelle		1-612-777-6755				1-312-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	02/16/2021	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Customer Service Operations Contact	Sr Director Member Contact		Gamble	LaTonya		1-904-905-2057					latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Government Relations Contact	Sr Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		1-904-445-8502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Hospice Contact	Medical Clinical Pharmacist Pharmacy Govt Prog		Adams	Tangela		1-904-905-0002					tangela.adams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 400, 3rd Floor	Jacksonville	FL	32246	01/24/2022	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Medicare Compliance Officer	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		1-904-445-8502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Part D Exceptions Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	1-800-477-3736	56307			PPO - BBA		C	Atlanta
H5434	Pharmacy Network Management Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		1-904-905-6307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5434	Pharmacy Technical Help Desk Contact	Director, Member Services		Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	07/19/2021	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	1-888-877-6420				PPO - BBA		C	Atlanta
H5434	Plan to Plan Reconciliation Contact	Accounting Specialist		Williams	Lynn		1-904-905-4568					lynn.williams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Atlanta
H5435	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PFFS - Private Fee for Service		C	San Francisco
H5435	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5435	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PFFS - Private Fee for Service		C	San Francisco
H5435	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	San Francisco
H5439	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H5439	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5439	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H5439	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5447	Automated TrOOP Balance Transfer Contact	Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	01/30/2020	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Best Available Evidence Contact	Director		Spaustat	Helen		1-210-510-2545					DL_CFHP_Regulatory@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	12/05/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Chief Financial Officer	Chief Financial Officer	Mr.	Isaac	Daverick		1-210-358-6013					DIsaac@cfhp.com	12238 Silicon Drive	STE 100	SAN ANTONIO	TX	78249	05/03/2021	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	CMS Casework Communication Contact	Executive Director Medicare & NM		Rodriguez	Martha		1-210-358-6190					mrodriguez2@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/14/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Coordination of Benefits Contact	Executive Director Medicare & NM		Rodriguez	Martha		1-210-358-6190					mrodriguez2@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/14/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Customer Service Operations Contact	Executive Director, Member Services		Gonzalez	Mary Helen		1-210-358-6062					MGonzalez@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	01/30/2020	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Government Relations Contact	Executive Director Medicare & NM		Rodriguez	Martha		1-210-358-6190					mrodriguez2@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/14/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Hospice Contact	Vice President, Population Health Management		Crow	Lisa		1-210-358-6126					jsimpson@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	01/30/2020	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Medicare Compliance Officer	Chief Compliance & Quality Officer	Ms.	Lomba	Susan		1-210-510-2463					DL_CFHP_Regulatory@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	12/05/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Exceptions Contact	Sr. Manager, Clinical Prior Authorization		LeClair	Christophe						1-920-221-4676	Christopher.LeClair@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/07/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Dallas
H5447	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@Navitus.com	361 Integrity Drive		Madison	WI	53717	04/07/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Acounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/07/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Dallas
H5447	Plan to Plan Reconciliation Contact	Manager, Finance		Romero	Lorena		1-210-358-6181					dl_cfhp_regulatory@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	12/05/2022	2023	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First Health Plans	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5454	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-614-336-3326				HMO - Health Maintenance Organization		C	Chicago
H5454	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5454	Pharmacy Technical Help Desk Contact			Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	08/04/2021	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H5454	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H5471	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5471	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H5471	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5472	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	San Francisco
H5472	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5472	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				HMO - Health Maintenance Organization		C	San Francisco
H5472	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5475	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/07/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/01/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5475	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5475	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/01/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H5475	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/01/2021	2023	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5493	Automated TrOOP Balance Transfer Contact	Regional Finance Director		Schmotzer	David		1-215-339-4533				1-610-271-9530	David.Schmotzer@Trinity-Health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	08/13/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Best Available Evidence Contact	Executive Director		Milligan	Amy	L	1-302-660-3352				1-302-575-8236	amilligan@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Chief Financial Officer	Regional Finance Director	Mr.	Schmotzer	David		1-215-339-4533				1-610-271-9530	David.Schmotzer@Trinity-Health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	08/13/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	CMS Casework Communication Contact	Executive Director		Milligan	Amy	L	1-302-660-3352				1-302-575-8236	amilligan@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Coordination of Benefits Contact	Regional Finance Director	Mr.	Schmotzer	David		1-215-339-4533				1-610-271-9530	David.Schmotzer@Trinity-Health.org	1930 South Broad Street	Unit 3	Philadelpia	PA	19145	08/13/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Customer Service Operations Contact	Quality Assurance and Compliance Part D Officer		Thomas	Clare	M	1-302-660-3359				1-302-575-8236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Government Relations Contact	Executive Director	Ms	Milligan	Amy	L	1-302-660-3352				1-302-575-8236	amilligan@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms	Hays Mcelroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/01/2020	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Part D Exceptions Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	08/13/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Philadelphia
H5493	Pharmacy Network Management Contact	Quality Assurance & Compliance Part D Officer	Ms	Thomas	Clare	M	1-302-660-3359				1-302-575-8236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Pharmacy Technical Help Desk Contact	Quality Assurance & Compliance Part D Officer	Ms	Thomas	Clare	M					1-302-575-8236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	1-302-660-3359				PACE - Nat		C	Philadelphia
H5493	Plan to Plan Reconciliation Contact	Regional Finance Director	Mr	Schmotzer	David		1-215-339-4533				1-610-271-4530	David.Schmotzer@Trinity-Health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	08/13/2021	2023	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5496	Automated TrOOP Balance Transfer Contact	Clinical Pharmacist		Cho	Evelyn		1-626-727-0465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	12/23/2021	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Best Available Evidence Contact	Membership Manger Sr.		Munoz	Alicia		1-626-838-5100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Chief Financial Officer	Chief Financial Officer	Mrs.	Bindra	Meeta		1-626-838-5100	5155				Meeta.Bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	04/16/2020	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	CMS Casework Communication Contact	Compliance Officer	Ms	Ruiz	Erica		1-562-239-5675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Coordination of Benefits Contact	Membership Manger Sr.		Munoz	Alicia		1-626-838-5100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Customer Service Operations Contact	Membership Manger Sr.		Munoz	Alicia		1-626-838-5100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Government Relations Contact	Compliance Officer	Ms	Ruiz	Erica		1-562-239-5675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Hospice Contact	CEO	Dr	Bindra	Pavel		1-626-838-5110				1-626-521-6028	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Medicare Compliance Officer	Compliance Officer	Ms	Ruiz	Erica		1-562-239-5675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Part D Exceptions Contact	Clinical Pharmacist		Cho	Evelyn							evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	12/23/2021	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	1-833-667-3497				HMO - Health Maintenance Organization		C	San Francisco
H5496	Pharmacy Network Management Contact	CEO	Dr	Cho	Evelyn		1-626-727-0465				1-626-521-6028	evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	07/28/2022	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5496	Pharmacy Technical Help Desk Contact	Vice president Operations		Conn	Todd							tconn@elixirsolutions.com	2181 E. Aurora Road	Suite 201	Twinsburg	OH	44087	11/24/2020	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	1-833-667-3497				HMO - Health Maintenance Organization		C	San Francisco
H5496	Plan to Plan Reconciliation Contact	Controller	Mrs	Bindra	Meeta		1-626-838-5100	5155			1-626-521-6028	meeta.bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	12/07/2021	2023	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5521	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-602-618-3945				PPO - BBA		C	Philadelphia
H5521	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5521	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-800-238-6279				PPO - BBA		C	Philadelphia
H5521	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-888-736-9118				1-888-554-7668	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/03/2018	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-602-618-3945				PPO - BBA		C	Philadelphia
H5522	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5522	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-800-238-6279				PPO - BBA		C	Philadelphia
H5522	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	HEALTHASSURANCE PENNSYLVANIA, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H5525	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H5525	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H5525	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5526	Automated TrOOP Balance Transfer Contact	Manager, Federal Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-3075	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Best Available Evidence Contact	Manager		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Chief Financial Officer	CFO Highmark Health Plan	Mr.	Veach	Daryl		1-412-544-7531					Daryl.Veach@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/14/2021	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	CMS Casework Communication Contact	Manager, Government Programs Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		1-412-544-4417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	06/03/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Customer Service Operations Contact	Manager, Member Customer Service		Sheridan	Rebecca	L	1-518-220-5661				1-518-423-2294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Government Relations Contact	SVP, Government Affiars	Mr.	Warfel	Michael	G	1-717-302-3979					michael.warfel@highmark.com	1800 Center St.		Camp Hill	PA	17011	03/18/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Hospice Contact	Intake Coordinator		Welker	Jessica		1-717-888-3043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	11/08/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		1-412-544-7031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite P4207	Pittsburgh	PA	15222	11/08/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active	1-800-600-2227				PPO - BBA		C	Philadelphia
H5526	Pharmacy Network Management Contact	Network Account Director, Retail Strategy&Contract		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/30/2016	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5526	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	12/17/2021	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active	1-800-922-1557				PPO - BBA		C	Philadelphia
H5526	Plan to Plan Reconciliation Contact	Manager, Federal Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	PO Box 80	Attention: Christa Dipasquale	Buffalo	NY	14240-0080	05/05/2022	2023	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark BCBS of WNY and Highmark BS of NENY	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H5528	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		1-860-674-5780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	06/25/2021	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Best Available Evidence Contact	Manager, Vendor Operations		Ewen	Jillian		1-860-674-5780					jewen@connecticare.com	175 Scott Swamp Road	P.O. Box 4050	Farmington	CT	06034-4050	03/23/2020	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		1-646-447-6174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	07/02/2020	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	CMS Casework Communication Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	1-646-447-7215				1-212-510-8130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	07/22/2022	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Coordination of Benefits Contact	Sr. Dir., Claims Operations & Provider Data Mgmt		Gauthier	Kathleen	H	1-860-409-6435					kgauthier@connecticare.com	55 Water Street		New York	NY	10041	07/15/2021	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Customer Service Operations Contact	VP, Ops Strategy & Service Delivery		Pandey	Priyank		1-646-447-7543					ppandey@emblemhealth.com	55 Water Street		New York	NY	10041	02/17/2021	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Government Relations Contact	Director, Medicare Compliance		Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/09/2019	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Hospice Contact	Senior Medicare Pharmacy Specialist		Der Weer	J'Nisha		1-646-447-7198					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2022	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/08/2019	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Exceptions Contact	Director		Colby	Andrew							acolby@emblemhealth.com	55 Water street		New York	NY	10041	05/12/2022	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active	1-646-447-3340				PPO - BBA		C	New York
H5528	Pharmacy Network Management Contact	Pharmacy Client Ops Director		Brown	Gregory		1-401-525-1683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2022	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	6625 West 78th street		Bloomington	MN	55439	01/24/2022	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active	1-800-922-1557	2			PPO - BBA		C	New York
H5528	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		1-646-447-3017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	08/16/2022	2023	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth Medicare PPO	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5533	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		1-412-454-5539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		1-412-454-5559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	07/18/2016	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	CMS Casework Communication Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		1-412-454-5250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		1-412-454-7664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/18/2012	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		1-412-454-8589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	08/29/2012	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active	1-800-396-4139				PPO - BBA		C	Philadelphia
H5533	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	10/31/2016	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5533	Pharmacy Technical Help Desk Contact	DIrector, Customer Service		Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	07/29/2021	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active	1-800-922-1557				PPO - BBA		C	Philadelphia
H5533	Plan to Plan Reconciliation Contact	Business Analyst		Michalski	Jeff		1-412-454-5715				1-412-454-2110	medicarereporting@upmc.edu	c/o UPMC Health Plan Attn: Dave Soltesz P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	10/03/2022	2023	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Philadelphia
H5538	Automated TrOOP Balance Transfer Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut St.		New Orleans	LA	70117	06/13/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	Best Available Evidence Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	Chief Financial Officer	Vice President of Finance	Ms.	Saxton	Kim		1-517-282-3826					saxtonk@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	CMS Casework Communication Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	Coordination of Benefits Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	Customer Service Operations Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	Government Relations Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms.	Hays McElroy	Carrie		1-734-343-2668					antonio.dias@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	Part D Exceptions Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph							joseph.garbarino@mercyhealth.org	1930 S. Broad Street	Unit 3	Philadelphia	PA	19145	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending	1-215-339-4362				PACE - Nat		C	Atlanta
H5538	Pharmacy Network Management Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5538	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr.	Dias	Antonio							antonio.dias@trinity-health.org	731 Montegut St.		New Orleans	LA	70117	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending	1-000-000-0000				PACE - Nat		C	Atlanta
H5538	Plan to Plan Reconciliation Contact	Vice President of Operations	Mr.	Dias	Antonio		1-917-703-5808					antonio.dias@trinity-health.org	731 Montegut Street		New Orleans	LA	70117	06/16/2022	2023	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5549	Automated TrOOP Balance Transfer Contact	Manager, Membership and Eligibility Unit	Ms.	Tang	Cheryl		1-212-760-3147					Cheryl.Tang@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	05/16/2019	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Best Available Evidence Contact	Manager, Membership and Eligibility Unit	Ms.	Tang	Cheryl		1-212-760-3147					Cheryl.Tang@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	05/16/2019	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Chief Financial Officer	CFO	Mr.	Patterson	Keith		1-212-609-4131					Keith.Patterson@vnsny.org	220 East 42nd Street	6th Floor	New York	NY	10017	08/03/2022	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	CMS Casework Communication Contact	Vice President, Compliance & Regulatory Affairs		Goggin-Callahan	Doug		1-347-804-8601					Douglas.Goggin-Callahan@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	03/11/2020	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Coordination of Benefits Contact	Manager, Membership and Eligibility Unit	Ms.	Tang	Cheryl		1-212-760-3147					Cheryl.Tang@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	05/16/2019	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Customer Service Operations Contact	Vice President, Contact Center Services & Admin	Ms.	Vitale	Nancy		1-212-626-8071					Nancy.Vitale@vnsny.org	500 7th Avenue	11th Floor	New York	NY	10018	10/17/2018	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Government Relations Contact	Vice President, Government Affairs	Mr.	Lowenstein	Daniel		1-212-609-1514					Dan.Lowenstein@vnsny.org	220 East 42nd Street	6th Floor	New York	NY	10017	10/10/2018	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Hospice Contact	Pharmacy Services Specialist	Ms.	Rahman	Ishrat		1-212-609-1751					Ishrat.Rahman@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/03/2022	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Medicare Compliance Officer	Vice President, Compliance & Regulatory Affairs	Mr.	Goggin-Callahan	Doug		1-347-804-8601					Douglas.Goggin-Callahan@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	03/11/2020	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Part D Exceptions Contact	Vice President, Pharmacy Services	Ms.	Shell	Sofya							Sofya.Shell@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/25/2019	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active	1-212-290-6557				HMO - Health Maintenance Organization		C	New York
H5549	Pharmacy Network Management Contact	Vice President, Pharmacy Services	Ms.	Shell	Sofya		1-212-290-6557					Sofya.Shell@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/25/2019	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5549	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/08/2022	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active	1-888-672-7205				HMO - Health Maintenance Organization		C	New York
H5549	Plan to Plan Reconciliation Contact	Manager, Membership and Eligibility Unit	Ms.	Tang	Cheryl		1-212-760-3147					Cheryl.Tang@vnsny.org	220 East 42nd Street	3rd Floor	New York	NY	10017	05/16/2019	2023	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5576	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Best Available Evidence Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Chief Financial Officer	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	CMS Casework Communication Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Coordination of Benefits Contact	Medicare Enrollment Supervisor	Mrs.	Drake	Michele		1-318-998-3083					mdrake@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Customer Service Operations Contact	Director of Member Services	Mrs.	Trichel	Amy		1-318-998-2870					atrichel@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Government Relations Contact	Deputy General Counsel	Mrs.	Harvey	Korey		1-225-297-2762					korey.harvey@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Hospice Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Part D Exceptions Contact	Director of Pharmacy	Mr.	Dearman	Clyde							cdearman@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-318-998-2710				HMO - Health Maintenance Organization		C	Dallas
H5576	Pharmacy Network Management Contact	Associate Director Pharmacy Network Management		Burdick	Tammy		1-920-221-4089					Tammy.Burdick@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5576	Pharmacy Technical Help Desk Contact	Pharmacy Director	Mr.	Dearman	Clyde							cdearman@vhpla.com	130 DeSiard St Suite 300		monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-866-704-0109				HMO - Health Maintenance Organization		C	Dallas
H5576	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Automated TrOOP Balance Transfer Contact	Enrollment VP		Rios	Hector		1-787-758-2500	2874				hector.rios@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Best Available Evidence Contact	VP & Medicare Compliance Officer		Pastrana	Isis	C	1-787-758-2500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Chief Financial Officer	Chief Financial Officer	Mr.	Aponte	Jose		1-787-758-2500	5022			1-787-622-2098	joseap@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	CMS Casework Communication Contact	Grievances & Appeals Director		Roman	Beatriz		1-787-758-2500	5799			1-787-620-7765	broman@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/15/2021	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Coordination of Benefits Contact	Classicare Enrollment & Reconciliation AVP		Campos	Jose		1-787-758-2500	2939				jose.campos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon, Second Floor	San Juan	PR	00918	07/28/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Customer Service Operations Contact	Service Operations AVP		Melendez	Rebecca		1-787-758-2500	5602			1-787-622-2463	rebeccam@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/28/2022	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Government Relations Contact	VP & Medicare Compliance Officer		Pastrana	Isis	C	1-787-758-2500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Hospice Contact	Utilization Management Director		Burgos	Grace		1-787-758-2500	5747				grace.burgos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	05/09/2022	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Medicare Compliance Officer	VP & Medicare Compliance Officer	Mrs.	Pastrana	Isis	C	1-787-758-2500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Part D Exceptions Contact	Pharmacy Clinical Operations VP		Rosado	Arelys							arelys.rosado@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	1-787-758-2500	5745			HMO - Health Maintenance Organization		C	New York
H5577	Pharmacy Network Management Contact	Pharmacy AVP		Serrano	Debra		1-787-758-2500	5743				dserrano@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5577	Pharmacy Technical Help Desk Contact	Utilization Management Director		Burgos	Grace							grace.burgos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/30/2022	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	1-844-633-1064				HMO - Health Maintenance Organization		C	New York
H5577	Plan to Plan Reconciliation Contact	Financial Reporting Manager		Perez	Javier		1-787-758-2500	2604				javperez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue Second Floor	San Juan	PR	00918	07/27/2020	2023	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Automated TrOOP Balance Transfer Contact	Director, Finance	Ms.	Wilson	Robyn		1-602-659-1424					WilsonR3@aetna.com	4500 E Cotton Center Blvd		Phoenix	AZ	85040	08/03/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Best Available Evidence Contact	Enrollment Services Manager	Ms.	Romero	Tammie		1-602-453-6054				1-602-414-7228	RomeroT@aetna.com	4500 E Cotton Center Blvd		Phoenix	AZ	85040	08/03/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Chief Financial Officer	Chief Financial Officer	Mr.	Ek	Randell		1-602-659-1457					EkR@mercycareplan.com	4500 E Cotton Center Blvd		Phoenix	AZ	85040	08/03/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	CMS Casework Communication Contact	Medicare Compliance Officer	Mrs	Macias	Christina		1-909-792-3937					MaciasC1@mercycareaz.org	4500 E Cotton Center Blvd		Phoenix	AZ	85040	11/03/2022	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Coordination of Benefits Contact	Director of Finance	Mr.	Chilton	Keith		1-602-453-8022					ChiltonK@aetna.com	4500 E Cotton Center Blvd		Phoenix	AZ	85040	08/03/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Customer Service Operations Contact	Director Customer Service	Ms.	Smith	Reesa		1-602-453-5588					Reesa.Smith@mercycareaz.org	4500 E Cotton Center Blvd		Phoenix	AZ	85040	08/03/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Government Relations Contact	Head of Medicare	Mr.	Patton	Jeff		1-602-453-8315					PattonJ@aetna.com	4500 E Cotton Center Blvd		Phoenix	AZ	85040	08/03/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Hospice Contact	Head of Medicare	Mr.	Patton	Jeff		1-602-453-8315					PattonJ@aetna.com	4500 E Cotton Center Blvd		Phoenix	AZ	85040	08/03/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Medicare Compliance Officer	Medicare Compliance Officer	Mrs	Macias	Christina		1-909-792-3937					MaciasC1@mercycareaz.org	4500 E Cotton Center Blvd		Phoenix	AZ	85040	11/03/2022	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Part D Exceptions Contact	Appeals Supervisor		Spencer	Tiffane						1-855-230-5544	SpencerT4@AETNA.com	4500 E Cotton Center Blvd		Phoenix	AZ	85040	05/20/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active	1-860-900-4547				HMO - Health Maintenance Organization		C	San Francisco
H5580	Pharmacy Network Management Contact	Director, Network Systems & Standards		Lindsey	Lisa		1-480-391-4503					Lisa.lindsey@cvshealth.com	9501 E Shea Blvd, MC080		Scottsdale	AZ	85260	12/24/2019	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5580	Pharmacy Technical Help Desk Contact	Pharmacy Help Desk	Mr.	Smith	Robert	W						Robert.Smith7@CVSHealth.com	750 W John Carpenter Fwy	MC:983	Irving	TX	75039	11/21/2018	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active	1-855-539-4721				HMO - Health Maintenance Organization		C	San Francisco
H5580	Plan to Plan Reconciliation Contact	Director of Finance	Mr.	Chilton	Keith		1-602-453-8022					ChiltonK@aetna.com	4500 E Cotton Center Blvd		Phoenix	AZ	85040	08/03/2021	2023	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Automated TrOOP Balance Transfer Contact	Controller		Patel	Achal		1-480-760-4813				1-480-760-4619	Achal.Patel@azblue.com	410 N 44th Street, Suite 900		Phoenix	AZ	85008	03/16/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Best Available Evidence Contact	Manager Operations Center- Call Center		Cruz Herrera	Elizabeth		1-480-303-4419				1-480-760-4708	Elizabeth.CruzHerrera@azblue.com	410 N 44th Street, Suite 510		Phoenix	AZ	85008	03/16/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Chief Financial Officer	Chief Financial Officer	Ms	Magallanes	Tammy		1-520-609-7835					Tammy.Magallanes@azblue.com	410 N 44th Street Suite 900		Phoenix	AZ	85008	05/20/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	CMS Casework Communication Contact	Vice President of Clinical Operations		Lewis	Ellen		1-480-212-7841				1-480-784-2933	Ellen.Lewis@azblue.com	410 N 44th Street, Suite 510		Phoenix	AZ	85008	03/16/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Coordination of Benefits Contact	Manager, Provider Asst. Customer Service Ops Medic		Williams	Tammy		1-800-322-8670				1-480-760-4708	tammy.williams@azblue.com	410 N 44th Street, Suite 900		Phoenix	AZ	85008	04/18/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Customer Service Operations Contact	Vice President of Operations Center - Call Center		Irmer	Suzan		1-480-333-4507				1-480-760-4708	Suzan.Irmer@azblue.com	410 N 44th Street, Suite 510		Phoenix	AZ	85008	03/16/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Government Relations Contact	Vice President of Medicare Operations		ladich	Matthew		1-480-303-4439					Matthew.Ladich@azblue.com	410 N 44th Street, Suite 900		Phoenix	AZ	85008	03/16/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Hospice Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		1-520-906-3358				1-888-908-6747	Stephanie.Sanders@azblue.com	410 N 44th Street, Suite 900		Phoenix	AZ	85008	03/16/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Medicare Compliance Officer	Director of Corporate & Medicare Compliance	Ms	Moore	Veronica		1-602-336-7600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	10/25/2021	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Part D Exceptions Contact	HCP Pharmacist		Rodriguez	Leslie							Leslie.Rodriguez@azblue.com	410 N 44th Street, Suite 510		Phoenix	AZ	85008	03/16/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-602-819-4784				HMO - Health Maintenance Organization		C	San Francisco
H5587	Pharmacy Network Management Contact	HCP Pharmacist		Rodriguez	Leslie		1-602-819-4784					Leslie.Rodriguez@azblue.com	410 N 44th Street, Suite 510		Phoenix	AZ	85008	03/16/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5587	Pharmacy Technical Help Desk Contact	Client Operations Advisor		Free	Jennifer						1-480-314-6432	Jennifer.Free@CVSHealth.com	CVS Health	9501 E. Shea Blvd	Scottsdale	AZ	85260	02/27/2020	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	San Francisco
H5587	Plan to Plan Reconciliation Contact	Controller		Patel	Achal		1-480-760-4813				1-480-760-4619	Achal.Patel@azblue.com	P.O. Box 743242		Los Angeles	CA	90074-3242	05/13/2022	2023	HEALTH CHOICE ARIZONA, INC.	Local CCP	Health Choice Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5590	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1850 W. Rio Salado Parkway		Tempe	AZ	85281	07/19/2022	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5590	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5590	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H5590	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5591	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Operations		Theriault	Anne		1-207-766-3144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Best Available Evidence Contact	Manager, Member Operations		Whelan	James		1-207-274-2738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Chief Financial Officer	Chief Financial Officer	Ms	Jackson	Amanda		1-207-253-6115					amanda.jackson@martinspoint.org	331 Veranda Street	P. O.  Box 9746	Portland	ME	04104	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	CMS Casework Communication Contact	Director Compliance & MCO		Loomis	Elizabeth		1-518-229-0535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Coordination of Benefits Contact	Manager, Member Operations		Whelan	James		1-207-274-2738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Customer Service Operations Contact	Director Compliance & MCO		Loomis	Elizabeth		1-518-229-0535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04101	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Government Relations Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		1-518-229-0535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Hospice Contact	Senior Medicare Part D Specialist		Creighton-Galinas	Sheila		1-207-828-2471					sheila.creighton-galinas@martinspoint.org	891 Washington Ave	PO Box 9746	Portland	ME	04104-5040	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Medicare Compliance Officer	Director Compliance & MCO	Ms	Loomis	Elizabeth		1-518-229-0535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Part D Exceptions Contact	Appeals Representative		Representative	Appeals							appealsmedicare@caremark.com	CVS Caremark	9501 E. Shea Blvd MC 109	Scottsdale	AZ	85260	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active	1-868-884-9479				HMO - Health Maintenance Organization		C	New York
H5591	Pharmacy Network Management Contact	Director, Network Operations		Smith	Shawn		1-480-391-4844				1-480-314-6964	Shawn.Smith@caremark.com	CVS Caremark	9501 E. Shea Blvd. MC143	Scottsdale	AZ	85260	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5591	Pharmacy Technical Help Desk Contact	Manager, Vendor Management		Palmieri	Mike							mike.palmieri@caremark.com	CVS Caremark	2401 Cherahala Blvd. MC650	Knoxville	TN	37932	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H5591	Plan to Plan Reconciliation Contact	Accountant III		Allard	Kathleen		1-207-828-2490					kathleen.allard@martinspoint.org	P. O. Box 9746	27 Northport Drive	Portland	ME	04104	12/23/2022	2023	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5593	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/11/2018	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/06/2019	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H5593	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5593	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H5593	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5594	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		1-813-506-6000	66072				PartD@freedomh.com	4200 W Cypress St	Suite 800	Tampa	FL	33607	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Best Available Evidence Contact	Vice President, Enrollment		Conner	Claudius		1-813-459-8739				1-813-506-6151	CMSEnrollment@freedomh.com	4200 W. Cypress Street		Tampa	FL	33607	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Chief Financial Officer	CFO	Ms	Newman	Elena		1-305-342-0885					cms@freedomh.com	9250 W Flagler St		Miami	FL	33174	06/28/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	CMS Casework Communication Contact	Compliance Officer		Kortsch	Diane		1-414-336-9395				1-813-506-6151	cms@freedomh.com	4200 Cypress St	Suite 800	Tampa	FL	33607	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Coordination of Benefits Contact	VP of Finance	Mr	Caruso	David		1-813-506-6000	11006			1-813-506-6151	CMSFinance@freedomh.com	4200 Cypress Street	Suite 800	Tampa	FL	33607	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Customer Service Operations Contact	Director of Member Services		Doroteo	Carlos		1-813-506-6000	11342			1-813-506-6150	CMSMemberServices@freedomh.com	4200 Cypress Street	Suite 500	Tampa	FL	33607	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Government Relations Contact	Compliance Officer	Ms	Kortsch	Diane		1-414-336-9395					cms@freedomh.com	4200 Cypress St	Suite 800	Tampa	FL	33607	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Hospice Contact	Pharmacist		Marrocco	Brianna		1-727-451-6800	66072			1-813-506-6152	PartD@freedomh.com	2240 Belleair Road	Suite 250	Clearwater	FL	33764	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Medicare Compliance Officer	Compliance Officer	Ms	Kortsch	Diane		1-414-336-9395				1-813-506-6151	CMSAccounting@freedomh.com	4200 Cypress St	Suite 800	Tampa	FL	33607	11/05/2021	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Part D Exceptions Contact	Pharmacist		Marrocco	Brianna						1-813-506-6152	bmarrocco@freedomh.com	2240 Belleair Rd Ste 250		Clearwater	FL	33762	01/08/2020	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-727-451-6800	66072			HMO - Health Maintenance Organization		C	Chicago
H5594	Pharmacy Network Management Contact	Director Of Operations-PR		Goluch	Adrian		1-813-506-6000	11354			1-813-506-6152	agoluch@freedomh.com	4200 Cypress Street	Suite 800	Tampa	FL	33607	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Pharmacy Technical Help Desk Contact	VP Rx Retail Network / Contracting IngenioRx Presi		Gettings	Darren							darren.gettings@Ingenio-RX.com	1831 Chestnut St		St Louis	MO	63103	01/02/2020	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4267				HMO - Health Maintenance Organization		C	Chicago
H5594	Plan to Plan Reconciliation Contact	P2P Contact		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd	Ste 100 Mailstop CA9304-R04H	Woodland Hills	CA	91367	03/01/2022	2023	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5599	Automated TrOOP Balance Transfer Contact	Director, Pharmacy	Ms.	Dindial	Sharon		1-718-896-6500					sdindial@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	05/11/2022	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Best Available Evidence Contact	Manager, Medicare Enrollment	Ms.	Almendarez	Celestina		1-718-393-6104					CAlmendarez@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	03/26/2021	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	05/11/2022	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/27/2022	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	01/31/2020	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	05/11/2022	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Hospice Contact	Senior Director, Long Term Care		Reed	Mark		1-317-217-0776					MAReed@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	06/15/2022	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Part D Exceptions Contact	Director, Medicare Pharmacy		Dindial	Sharon						1-877-882-5892	sdindial@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	01/12/2022	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-929-218-0035				HMO - Health Maintenance Organization		C	Dallas
H5599	Pharmacy Network Management Contact	VP, Contract Management	Ms.	Stubblefield	Brenda		1-718-906-0850					bstubblefield@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	03/26/2021	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5599	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Dallas
H5599	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare by Fidelis Care	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Judge	April		1-858-790-7010				1-858-790-6052	PartDCAT@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	04/14/2014	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Best Available Evidence Contact	Government Products Manager		Chrissinger	Cailey		1-303-602-2427				1-303-602-2094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Chief Financial Officer	CFO	Mr.	Caldwell	Joseph		1-303-602-0634				1-303-602-2094	Joseph.Caldwell@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	06/28/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	CMS Casework Communication Contact	Government Products Manager		Chrissinger	Cailey		1-303-602-2427				1-303-602-2094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/11/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Coordination of Benefits Contact	Business Analyst, Payment Integrity		Manning	Linda		1-303-602-2702				1-303-602-2094	Linda.Manning@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	04/15/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Customer Service Operations Contact	Chief Administrative Officer		Wagner	Michael		1-303-602-2595					Michael.Wagner@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	80204-4507	04/12/2018	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Government Relations Contact	Government Products Manager		Chrissinger	Cailey		1-303-602-2427				1-303-602-2094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Hospice Contact	Government Products Manager		Chrissinger	Cailey		1-303-602-2427				1-303-602-2094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Artale Bross	Lisa		1-303-602-4347				1-303-602-7024	lisa.artalebross@dhha.org	601 Broadway	Mail Code 7776	Denver	CO	80204	09/27/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Part D Exceptions Contact	Pharmacy Director		Winters	Ruie							Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	80204-4507	06/28/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active	1-303-602-0604				HMO - Health Maintenance Organization		C	Dallas
H5608	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148				1-858-790-6011	Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/14/2014	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5608	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	01/12/2021	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active	1-877-391-9291				HMO - Health Maintenance Organization		C	Dallas
H5608	Plan to Plan Reconciliation Contact	Financial Analyst		Schreiber	Mark		1-303-602-2497				1-303-602-2094	Mark.Schreiber@dhha.org	777 Bannock	Mail Code 6000	Denver	CO	80204	08/10/2022	2023	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5610	Automated TrOOP Balance Transfer Contact	Director of Quality		Poeller	Dawn		1-616-913-2012				1-616-913-2003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Best Available Evidence Contact	Director of Quality		Poeller	Dawn		1-616-913-2012				1-616-913-2003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Chief Financial Officer	CFO	Mr.	Quist	Steve		1-616-235-5123				1-616-235-5680	steve.quist@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	06/24/2021	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	CMS Casework Communication Contact	Director of Quality		Poeller	Dawn		1-616-913-2012				1-616-913-2003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Coordination of Benefits Contact	Director of Claims		Haggerty	Becky		1-616-954-1578				1-616-954-1520	becky.haggerty@relianceccp.org	2100 Raybrook SE	Suite 203	Grand Rapids	MI	49506	08/07/2019	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Customer Service Operations Contact	Director of Quality		Poeller	Dawn		1-616-913-2012				1-616-913-2005	dawn.poeller@careresources.org	1471 Grace Street		Grand Rapids	MI	49506	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Government Relations Contact	CEO		McKnight	Tracey		1-616-913-2011				1-616-913-2003	tracey.mcknight@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49506	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Medicare Compliance Officer	Director of Quality	Ms.	Poeller	Dawn		1-616-913-2012				1-616-913-2003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part D Exceptions Contact	Director of Quality		Poeller	Dawn						1-616-913-2003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active	1-800-610-6299	2012			PACE - Nat		C	Chicago
H5610	Pharmacy Network Management Contact	Pharmacist		Hoholik	Aaron		1-616-913-2032				1-616-913-2037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Pharmacy Technical Help Desk Contact	Pharmacist		Hoholik	Aaron						1-616-913-2037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active	1-180-061-0629				PACE - Nat		C	Chicago
H5610	Plan to Plan Reconciliation Contact	Director of Quality		Poeller	Dawn		1-616-913-2012				1-616-913-2003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2023	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5619	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H5619	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H5619	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5622	Automated TrOOP Balance Transfer Contact	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	Best Available Evidence Contact	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	Chief Financial Officer	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	CMS Casework Communication Contact	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	Coordination of Benefits Contact	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	Customer Service Operations Contact	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	Government Relations Contact	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	Medicare Compliance Officer	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	Part D Exceptions Contact	Project Manager	Ms.	Lozado	Karen							klozado@hosparus.org	6200 Dutchman''s Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending	1-502-599-0175				PACE - Nat		C	Atlanta
H5622	Pharmacy Network Management Contact	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5622	Pharmacy Technical Help Desk Contact	Project Manager	Ms.	Lozaado	Karen							klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending	1-502-599-0175				PACE - Nat		C	Atlanta
H5622	Plan to Plan Reconciliation Contact	Project Manager	Ms.	Lozado	Karen		1-502-599-0175					klozado@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	09/13/2022	2023	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H5628	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H5628	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5628	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H5628	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5629	Automated TrOOP Balance Transfer Contact	Health Plan Manager	Mrs.	Jones	Cassandra		1-619-677-3800				1-619-677-3888	cjones@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	Best Available Evidence Contact	Marketing Director		Gois	Amanda		1-619-677-3800				1-619-677-3888	marketing@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	Chief Financial Officer	Chief Financial Officer	Mr.	Sanner	Randall		1-619-239-6900				1-619-239-1256	rsanner@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	05/27/2020	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	CMS Casework Communication Contact	Health Plan Manager	Mrs.	Jones	Cassandra		1-619-677-3800				1-619-677-3888	cjones@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	Coordination of Benefits Contact	Health Plan Manager	Mrs.	Jones	Cassandra		1-619-677-3800				1-619-677-3888	cjones@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	Customer Service Operations Contact	Operations Director	Mr.	Aldrete	Alberto		1-619-677-3800				1-619-677-3888	aaldrete@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	Government Relations Contact	Chief Executive Officer/Executive Director		Hubbard	Carol		1-619-677-3800				1-619-677-3888	director@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	Medicare Compliance Officer	Chief Administrative Officer	Mr.	Frazier	Tim		1-619-239-6900				1-619-239-1256	tfrazier@stpaulseniors.org	328 Maple St		San Diego	CA	92103	04/26/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	Part D Exceptions Contact	Medical Director	Dr.	Lee	Victor						1-619-677-3888	vlee@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active	1-180-073-5292				PACE - Nat		C	San Francisco
H5629	Pharmacy Network Management Contact	Health Plan Manager	Mrs.	Jones	Cassandra		1-619-677-3800				1-619-677-3888	cjones@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5629	Pharmacy Technical Help Desk Contact	Health Plan Manager	Mrs.	Jones	Cassandra						1-619-677-3888	cjones@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active	1-800-735-2922				PACE - Nat		C	San Francisco
H5629	Plan to Plan Reconciliation Contact	Health Plan Manager	Mrs.	Jones	Cassandra		1-619-677-3800				1-619-677-3888	cjones@stpaulspace.org	111 Elm Street		San Diego	CA	92101	03/01/2022	2023	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul’s Episcopal Home	653	Yes	Active					PACE - Nat		C	San Francisco
H5644	Automated TrOOP Balance Transfer Contact	Vice President - Pharmacy	Mr	Regalia	Ted		1-920-720-1654				1-920-720-1906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Best Available Evidence Contact	Director, Operations		Techlin	Cara		1-920-720-1502				1-920-720-1931	ctechlin@networkhealth.com	1570 Midway Place		Menasha	WI	54952	12/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Chief Financial Officer	Chief Financial Officere	Mr	Ollech	Brian		1-920-720-1886					bollech@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	CMS Casework Communication Contact	Director, Regulatory Affairs		Schuster	Shannon		1-920-628-7267					sschuste@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Coordination of Benefits Contact	Director - Pharmacy		Wheaton	Andy		1-920-720-1612				1-920-720-1906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Customer Service Operations Contact	Manager, Customer Service		Schwandner	Stacy		1-920-720-1309				1-920-720-1908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Government Relations Contact	Compliance Officer		Keenan	Angela		1-920-720-1242					nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Hospice Contact	Pharmacy Lead		Kempfer	Amanda		1-920-720-1607					pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Medicare Compliance Officer	Compliance Officer	Mrs.	Keenan	Angela		1-920-720-1242				1-920-720-1912	nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Part D Exceptions Contact	Director, Provider Integration		Delebreau	Jennifer						1-920-720-1908	jdelebre@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active	1-800-378-5234				HMO - Health Maintenance Organization		C	Chicago
H5644	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5644	Pharmacy Technical Help Desk Contact	Director - Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy STE 150		Temple Terrace	FL	33637	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H5644	Plan to Plan Reconciliation Contact	Vice President - Finance		Leigh	Dennis		1-920-720-1837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	11/01/2022	2023	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Farb	Mike		1-612-400-3275					mfarb@brighthealthcare.com	8000 Norman Center Drive		Minneapolis	MN	55437	12/15/2022	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Best Available Evidence Contact	Director of Information Systems	Mr.	Kirby	Kevin	W	1-626-388-2383				1-626-388-2317	kkirby@centralhealthplan.com	1540 Bridgegate Drive		Diamond Bar	CA	91765	09/21/2011	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Chief Financial Officer	CFO	Mr.	Uma	Chet		1-626-388-2390	2895				chetuma@centralhealthplan.com	1540 Bridgegate Drive		Diamond Bar	CA	91765	12/31/2020	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	CMS Casework Communication Contact	Senior Compliance Counsel	Mrs.	Shieh	Annie	H	1-626-388-2390	2885			1-626-388-2367	ahsu@centralhealthplan.com	1540 Bridgegate Drive		Diamond Bar	CA	91765	02/11/2013	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Coordination of Benefits Contact	Director, Pharmacy Operations	Mr.	Farb	Mike		1-612-400-3275					mfarb@brighthealthcare.com	8000 Norman Center Drive		Minneapolis	MN	55437	12/15/2022	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Customer Service Operations Contact	Director of Member Services	Ms.	Huang	Judy		1-626-388-2390	1128				jhuang@centralhealthplan.com	1540 Bridgegate Drive		Diamond Bar	CA	91765	08/05/2016	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Government Relations Contact	Senior Compliance Counsel	Mrs.	Shieh	Annie	H	1-626-388-2390	2885			1-626-388-2367	ahsu@centralhealthplan.com	1540 Bridgegate Drive		Diamond Bar	CA	91765	02/11/2013	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Hospice Contact	Director, Pharmacy Operations		Farb	Mike		1-612-400-3275					mfarb@brighthealthcare.com	8000 Norman Center Drive		Minneapolis	MN	55437	12/15/2022	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Medicare Compliance Officer	Senior Compliance Counsel	Mrs.	Shieh	Annie		1-626-388-2390	2885			1-626-388-2367	ahsu@centralhealthplan.com	1540 Bridgegate Drive		Diamond Bar	CA	91765	11/10/2020	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer PKWY		Dublin	OH	43017	12/15/2022	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	Chicago
H5649	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/15/2022	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5649	Pharmacy Technical Help Desk Contact	Director, Customer Services		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N Telecom PKWY	STE 150	Temple Terrace	FL	33637	12/15/2022	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active	1-877-728-0177				HMO - Health Maintenance Organization		C	Chicago
H5649	Plan to Plan Reconciliation Contact	Director of Information Systems	Mr.	Kirby	Kevin	W	1-626-388-2383				1-626-388-2317	kkirby@centralhealthplan.com	1540 Bridgegate Drive		Diamond Bar	CA	91765	09/21/2011	2023	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Bright Health Group, Inc.	663	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5652	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/18/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H5652	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5652	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/30/2020	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H5652	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5703	Automated TrOOP Balance Transfer Contact	Manager of Technical Delivery and Oversight		Gajarajan	Nivi		1-267-825-8648				1-507-444-7774	ngajarajan2@performrx.com	PerformRx	200 Stevens Dr.	Philadelphia	PA	19113	05/26/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Best Available Evidence Contact	Director of Operations		Lewer	Cheryl		1-507-431-6377				1-507-444-7774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Chief Financial Officer	Chief Financial Officer	Mr	Schufman	Scott		1-507-431-6599				1-507-444-7774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	CMS Casework Communication Contact	Grievance and Appeals Manager		Miller	Suzette		1-507-431-6373				1-507-444-7774	sumiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Coordination of Benefits Contact	Director of Operations		Lewer	Cheryl		1-507-431-6377				1-507-444-7774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Customer Service Operations Contact	Director of Operations		Lewer	Cheryl		1-507-431-6377				1-507-444-7774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Government Relations Contact	Compliance and Government Relations Manager		Krenz	Kayla		1-507-431-6938				1-507-444-7774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Hospice Contact	Director of Health Services		Worrall	Kim		1-507-431-6397				1-507-444-7774	kworrall@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Medicare Compliance Officer	Compliance Officer	Mr	Marks	Jeff		1-507-431-6068				1-507-444-7774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Part D Exceptions Contact	Director of Pharmacy Utilization Management		Bonko	Gerald						1-215-863-5100	gbonko@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/01/2016	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	1-215-863-6483				HMO - Health Maintenance Organization		C	Chicago
H5703	Pharmacy Network Management Contact	Director, Service Operations		Leal	Avelina		1-215-863-6540					aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	04/28/2022	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5703	Pharmacy Technical Help Desk Contact	Director, Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/04/2015	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	1-866-935-6681				HMO - Health Maintenance Organization		C	Chicago
H5703	Plan to Plan Reconciliation Contact	Controller		Toquam	Erica		1-507-431-6591				1-507-444-7774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2023	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H5746	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5746	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H5746	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Local CCP	Amerigroup Community Care of New Mexico	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5774	Automated TrOOP Balance Transfer Contact	MA Revenue Management Director	Mr	Rosich	Luis		1-787-975-1365	8321176			1-787-993-3257	lrosich@sssadvantage.com	PO Box 11320		San Juan	PR	00922	11/01/2019	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Best Available Evidence Contact	MA Enrollment & Reconciliation Director		Toste	Maria		1-787-749-4949	8322541			1-787-522-4307	mtoste@sssadvantage.com	PO Box 11320		San Juan	PR	00922	06/09/2020	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Chief Financial Officer	CFO & EVP	Mr.	Haddock	Victor	J	1-787-749-4949	8324531			1-787-706-4041	victor.haddock@ssspr.com	P.O. Box 363628		San Juan	PR	00936-3628	05/17/2021	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	CMS Casework Communication Contact	Appeals and Grievances Manager	Mrs	Martinez	Aixa		1-787-749-4949	8322307			1-787-993-3261	aixam@sssadvantage.com	PO Box 11320		San Juan	PR	00922	08/12/2020	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Coordination of Benefits Contact	MA Enrollment & Reconcilliation Director	Mrs.	Toste	Maria		1-787-749-4949	8322541			1-787-522-4307	mtoste@sssadvantage.com	PO Box 11320		San Juan	PR	00922	04/26/2022	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Customer Service Operations Contact	Customer Service Manager	Mr	Jaxon	Harold		1-787-664-9288				1-787-620-0931	harold.jaxon@ssspr.com	PO Box 363628		San Juan	PR	00922	12/21/2022	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Government Relations Contact	Compliance Officer & VP	Ms	Cardenas	Jenny		1-787-749-4949	8322438			1-787-993-3260	jennycar@sssadvantage.com	PO Box 11320		San Juan	PR	00922	03/09/2020	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Hospice Contact	Medical Director	Mrs	Rivas	Jadeyra		1-787-749-4949	8322358			1-787-522-4004	jadeyra.rivas@ssspr.com	PO Box 11320		San Juan	PR	00922	03/30/2022	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Medicare Compliance Officer	Compliance Officer & VP	Mrs	Cardenas	Jenny	D	1-787-749-4949	8322438			1-787-993-3260	jennycar@sssadvantage.com	PO Box 11320		San Juan	PR	00922-9905	03/09/2020	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Part D Exceptions Contact	Pharmacy Senior Manager	Mrs	Graxirena	Dalia						1-787-522-4004	dgraxire@sssadvantage.com	PO Box 11320		San Juan	PR	00922	03/30/2022	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	1-787-749-4949	8321812			HMO - Health Maintenance Organization		C	New York
H5774	Pharmacy Network Management Contact	Director of Service Operations		Hernandez	Hector		1-787-523-1212	1123				hector.hernandez@abarcahealth.com	650 Avenida Muñoz Rivera	Suite 701	San Juan	PR	00918	01/04/2021	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5774	Pharmacy Technical Help Desk Contact	Director of Service Operations		Hernandez	Hector						1-787-523-1240	hector.hernandez@abarcahealth.com	650 Avenida Muñoz Rivera	Suite 701	San Juan	PR	00918	01/04/2021	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	1-855-922-2722				HMO - Health Maintenance Organization		C	New York
H5774	Plan to Plan Reconciliation Contact	MA Revenue Management Director	Mr	Rosich	Luis		1-787-975-1365	8321176			1-787-993-3257	lrosich@sssadvantage.com	PO Box 11320		San Juan	PR	00922	11/01/2019	2023	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5779	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/07/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H5779	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H5779	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5793	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/14/2020	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H5793	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5793	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H5793	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5810	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H5810	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5810	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H5810	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5822	Automated TrOOP Balance Transfer Contact	Director of Medical	Mrs.	Hashmi	Bushra		1-785-232-2044	1130			1-785-232-5567	bhashmi@midlandcc.org	200 SW Frazier Circle	Building A	Topeka	KS	66606	03/10/2020	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	Best Available Evidence Contact	Regional Director of PACE		Stroud-Brush	Jancy		1-785-232-2044				1-785-232-5567	jbrush@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	Chief Financial Officer	CFO	Mrs.	Crabb	Cynthia		1-785-232-2044				1-785-232-5567	ccrabb@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/11/2018	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	CMS Casework Communication Contact	Director of Quality		Reeves	Johnathan		1-785-232-2044				1-785-232-5567	jreeves@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	Coordination of Benefits Contact	Regional Director of PACE		Stroud-Brush	Jancy		1-785-232-2044				1-785-232-5567	jbrush@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	Customer Service Operations Contact	Interim VP/Executive Director of PACE		Webb-Cohen	Candace		1-785-232-2044				1-785-232-5567	ccohen@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	Government Relations Contact	President/CEO		Sullivan	Shawn		1-785-232-2044				1-785-232-5567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	12/31/2020	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	Medicare Compliance Officer	Director of Quality and Compliance	Ms	Corpstein	Joann		1-785-979-4321				1-785-232-5567	jcorpstein@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	02/19/2020	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	Part D Exceptions Contact	CMO		Wiles	Mark						1-785-232-5567	mwiles@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active	1-785-232-2044				PACE - Nat		C	Kansas City
H5822	Pharmacy Network Management Contact	Interim VP/Executive Director of PACE		Webb-Cohen	Candace		1-785-232-2044				1-785-232-5567	ccohen@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5822	Pharmacy Technical Help Desk Contact	Interim VP/Executive Director of PACE		Webb-Cohen	Candace						1-785-232-5567	ccohen@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active	1-785-232-2044				PACE - Nat		C	Kansas City
H5822	Plan to Plan Reconciliation Contact	CFO		Crabb	Cynthia		1-785-232-2044				1-785-232-5567	ccrabb@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/11/2018	2023	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	Kansas City
H5823	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H5823	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5823	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H5823	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5826	Automated TrOOP Balance Transfer Contact	Senior Accountant		Slack	Lynne		1-206-652-7148				1-206-521-8834	Lynne.Slack@chpw.org	1111 Third Ave, Suite 400		Seattle	WA	98101	05/11/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Best Available Evidence Contact	Sr. Director of Customer Experience		Norwood	Charyl		1-206-613-8885				1-206-521-8834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	07/21/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Chief Financial Officer	Chief Financial Officer	Ms	Kessel	Stacy		1-206-613-8963				1-206-521-8834	stacy.kessel@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	CMS Casework Communication Contact	Sr. Director of Customer Experience		Norwood	Charyl		1-206-613-8885				1-206-521-8834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	07/21/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Coordination of Benefits Contact	Sr Director of Customer Experience		Norwood	Charyl		1-206-613-8885				1-206-521-8834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	07/21/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Customer Service Operations Contact	Director of Customer Service		Leibbrand	Julie		1-206-652-7268				1-206-521-8834	julie.leibbrand@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Government Relations Contact	Sr Director State Programs & Medicare Strategy		Ayerza	Gabriel		1-206-652-7204				1-206-521-8834	gabriel.ayerza@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	12/30/2020	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Hospice Contact	Director of Pharmacy		Daoud	Omar		1-206-475-5779				1-206-521-8834	omar.daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Medicare Compliance Officer	VP, Compliance Officer	Ms	Zerda	Marie	A	1-206-613-5091				1-206-652-7017	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	05/05/2022	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	Seattle
H5826	Pharmacy Network Management Contact	Sr Manager- Network Contracting		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/23/2015	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5826	Pharmacy Technical Help Desk Contact	Director Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY	STE 150	Temple Terrace	FL	33637	11/22/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Seattle
H5826	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Slack	Lynne		1-206-652-7148				1-206-521-8834	Lynne.Slack@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2023	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5828	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H5828	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H5828	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	AMERIGROUP TENNESSEE, INC.	Local CCP	AMERIGROUP Community Care	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5843	Automated TrOOP Balance Transfer Contact	Supervisor Financial Analysis Consultant	Mr	Marshall	Gregory		1-480-684-5209					Gregory.Marshall@bannerhealth.com	2901 N. Central Ave Ste. 160		Phoenix	AZ	85012	12/27/2021	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Best Available Evidence Contact	Medicare Enrollment Sr. Mgr.	Mrs	Paredes	Nadya		1-520-874-5964				1-520-874-7083	Nadya.Paredes@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	01/26/2021	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Chief Financial Officer	Chief Financial Officer	Mr.	Aubrey	Rob		1-832-540-2074					Rob.Aubrey@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	03/07/2022	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	CMS Casework Communication Contact	Director, Grievance and Appeals	Mr	Maccioli	James		1-520-874-3247				1-520-874-7083	James.Maccioli2@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	12/20/2021	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Coordination of Benefits Contact	Director Reimbursement Services		Groves	Lori		1-602-469-2249					Lori.Groves@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/30/2021	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Customer Service Operations Contact	Customer Care Director	Mrs	Carrillo	Veronica		1-520-874-5349				1-520-874-7083	Veronica.Carrillo@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	02/14/2021	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Government Relations Contact	Government Programs Sr. Director	Mr.	Thomsen	Ryan		1-520-780-8310					ryan.thomsen@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	04/19/2022	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Hospice Contact	Pharmacy Director	Mr	Pokorney	Tim		1-602-747-2101					Timothy.Pokorney@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	09/27/2021	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Medicare Compliance Officer	Compliance Senior Director	Ms	Corlette	Kristina		1-602-747-2431					BMAComplianceOfficer@BannerHealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/05/2022	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Part D Exceptions Contact	Express Scripts Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	Express Scripts	5151 Blazer Pkwy	Dublin	OH	43017	12/21/2021	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	San Francisco
H5843	Pharmacy Network Management Contact	Express Scripts Network Accountant Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	12/21/2021	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5843	Pharmacy Technical Help Desk Contact	Express Scripts (Director, Customer Services)		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	Express Scripts	13051 N Telecom PKWY STE 150	Temple Terrace	FL	33637	12/16/2022	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active	1-800-903-6215				HMO - Health Maintenance Organization		C	San Francisco
H5843	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Aubrey	Rob		1-832-540-2074					Rob.Aubrey@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	03/07/2022	2023	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage Prime	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager	Mr.	Zlotkus	Steve		1-858-790-6250					partdcat@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/16/2019	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Best Available Evidence Contact	Health Plan Administrator	Mr.	O'Malley	Michael		1-323-337-9172				1-888-235-8482	michael.omalley@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Chief Financial Officer	Chief Financial Officer	Mr.	Honig Mojica	Lyle		1-323-860-5244				1-323-962-8513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	03/14/2022	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	CMS Casework Communication Contact	Risk Manager, Grievance & Appeals	Ms.	Beneche	Emelyne		1-954-522-3132	53292			1-888-965-7430	emelyne.beneche@aidshealth.org	700 SE 3rd Ave, 4th Floor		Fort Lauderdale	FL	33316	04/28/2022	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Coordination of Benefits Contact	Health Plan Administrator	Mr.	O'Malley	Michael		1-323-337-9172				1-888-235-8482	michael.omalley@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Customer Service Operations Contact	Health Plan Administrator	Mr.	O'Malley	Michael		1-800-263-0067				1-888-235-8482	michael.omalley@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Government Relations Contact	Chief of Managed Care	Ms.	Stidham	Donna	M	1-805-660-0703				1-323-337-9141	donna.stidham@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Hospice Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		1-323-436-5005				1-888-238-2244	anthony.dao@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Medicare Compliance Officer	Compliance Officer	Ms.	Holzner	Sandra		1-323-337-9153					sandra.holzner@ahf.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	01/11/2022	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Part D Exceptions Contact	Pharmacy Director - Managed care	Mr.	Dao	Anthony						1-888-238-2244	anthony.dao@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	1-888-554-1334				HMO - Health Maintenance Organization		C	San Francisco
H5852	Pharmacy Network Management Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		1-323-436-5005				1-888-238-2244	anthony.dao@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5852	Pharmacy Technical Help Desk Contact	Pharmacy Director - Managed care	Mr.	Dao	Anthony						1-888-238-2244	anthony.dao@aidshealth.org	6255 W Sunset Blvd 19th Floor		Los Angeles	CA	90028	12/29/2020	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	1-888-554-1334				HMO - Health Maintenance Organization		C	San Francisco
H5852	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Honig Mojica	Lyle		1-323-860-5244				1-323-860-5283	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	04/28/2022	2023	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5854	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H5854	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5854	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H5854	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5859	Automated TrOOP Balance Transfer Contact	Pharmacy Benefit Coordinator		Stone	Amber		1-503-416-4941					stonea@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	08/19/2021	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Best Available Evidence Contact	Enrollment Supervisor		Schulte	Rachel		1-503-416-8908				1-503-416-3723	schulter@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Chief Financial Officer	CFO	Ms.	Learn	Teresa		1-503-416-1415				1-503-416-8101	learnt@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	03/15/2018	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	CMS Casework Communication Contact	Medicare Program Manager		Duran Rey	Whitney		1-503-416-8040				1-503-416-3720	duranreyw@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	07/15/2022	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Coordination of Benefits Contact	Enrollment Manager		Foster	Cody		1-503-416-7887				1-503-416-3723	COBServices@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/18/2022	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Customer Service Operations Contact	Customer Service Manager		Mattila	Karen		1-503-416-8033				1-503-416-3723	mattilak@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	08/19/2021	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Government Relations Contact	Chief of Staff		Rigsby	Jeremiah		1-503-416-4699				1-503-416-3720	rigsbyj@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Hospice Contact	Pharmacy Clinical Coordinator Medicare Lead		Nguyen	Viet		1-503-416-1429				1-503-416-1428	nguyent@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	03/15/2018	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Medicare Compliance Officer	VP  Audit and Compliance	Mr	Zorn	Christian		1-503-416-4700				1-503-416-8117	zornc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	10/28/2022	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Part D Exceptions Contact	Pharmacy Clinical Coordinator Medicare Lead		Nguyen	Viet						1-503-416-1428	nguyent@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	03/15/2018	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	1-503-416-1429				HMO - Health Maintenance Organization		C	Seattle
H5859	Pharmacy Network Management Contact	Manager Retail Network Operations		Hagan	Kyle		1-303-989-5828				1-877-339-0784	Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	08/19/2021	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5859	Pharmacy Technical Help Desk Contact	Senior Director, Member Services		Nunnally	Josh							josh.nunnally@optum.com	11000 Optum Cir		Eden Prarie	MN	55344	12/13/2022	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	1-866-325-7344				HMO - Health Maintenance Organization		C	Seattle
H5859	Plan to Plan Reconciliation Contact	Financial Reporting & Analysis Manager		Lin	Echo		1-503-416-1414				1-503-416-8101	line@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	04/11/2018	2023	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5883	Automated TrOOP Balance Transfer Contact	Manager	Mr.	Nalamolu	Chandra		1-248-665-4549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1705	Detroit	MI	48226	10/08/2019	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Best Available Evidence Contact	Manager	Mrs.	Love	Lonita		1-248-223-5350					LLove@bcbsm.com	20500 Civic Center Drive	C300	Southfield	MI	48075	10/08/2019	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Chief Financial Officer	VP, Finance and Treasurer	Mr.	Harris	Waymond	E	1-313-225-6544					WHarris@bcbsm.com	600 E. Lafayette	MC 1800	Detroit	MI	48226	06/07/2021	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	CMS Casework Communication Contact	Manager	Mrs.	Love	Lonita		1-248-223-5350					LLove@bcbsm.com	20500 Civic Center Drive	C300	Southfield	MI	48075	10/08/2019	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Coordination of Benefits Contact	Manager, Claims Administration		Shippy	Karen		1-800-450-3680					KShippy@bcbsm.com	611 Cascade West Parkway, S.E.	G801	Grand Rapids	MI	49546	05/04/2018	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Customer Service Operations Contact	Director	Ms.	Judson	Johanna		1-313-225-5856					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Government Relations Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Hospice Contact	Manager	Mrs.	Rawson	Lori		1-616-956-5796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/03/2022	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Part D Exceptions Contact	Manager	Mr.	Petkoff	Ryan						1-800-459-8027	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/16/2020	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-437-3803				HMO - Health Maintenance Organization		C	Chicago
H5883	Pharmacy Network Management Contact	Director	Mr.	Perry	Glen		1-313-448-5949					gperry1@bcbsm.com	600 East Lafayette Blvd.	512H	Detroit	MI	48226	06/17/2022	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5883	Pharmacy Technical Help Desk Contact	Mgr	Mrs.	Rawson	Lori							lrawson@bcbsm.com	600 East Lafayette Blvd., TC 1309	ESI (or PBM) toll free number. DO NOT CHANGE!	Detroit	MI	48226	01/04/2021	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H5883	Plan to Plan Reconciliation Contact	Financial Coordinator, Finance and Accounting	Ms.	Tomasic	Cynthia		1-248-455-2726					bcnp2padmin@bcbsm.com	600 East Lafayette Blvd.	MC 0802	Detroit	MI	48226	03/25/2022	2023	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5900	Automated TrOOP Balance Transfer Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	03/31/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Best Available Evidence Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	02/09/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Chief Financial Officer	SVP, Controller	Mr.	Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/11/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	CMS Casework Communication Contact	Compliance Consultant		White	Jasmin		1-248-665-4235					JWhite4@bcbsm.com	1000 Town Center		Southfield	MI	48075	04/26/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Coordination of Benefits Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	03/22/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Customer Service Operations Contact	Director, Workforce Management, Analytics, & Supp		Weber	Julie		1-313-225-0555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	11/15/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Government Relations Contact	Manager, Program Oversight		Martell	Stacey		1-313-806-5905					smartell@bcbsm.com	1000 Town Center		Southfield	MI	48075	02/11/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Hospice Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Part D Exceptions Contact	Director, Medicare Programs		Frank	Jesica							frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-855-344-0930				PPO - BBA		C	Chicago
H5900	Pharmacy Network Management Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/26/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5900	Pharmacy Technical Help Desk Contact	Director, Medicare Programs		Frank	Jesica							frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/26/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-600-8065				PPO - BBA		C	Chicago
H5900	Plan to Plan Reconciliation Contact	SVP, Controller	Mr.	Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/11/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H5902	Automated TrOOP Balance Transfer Contact	NA	Mr.	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	Best Available Evidence Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	Chief Financial Officer	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	CMS Casework Communication Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	Coordination of Benefits Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	Customer Service Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	Government Relations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	Medicare Compliance Officer	Executive Director	Mrs.	Miloro	Roxanne		1-814-472-6060	27004				RMiloro@SeniorLifeEbensburg.com	429 Manor Drive		Ebensburg	PA	15931	12/09/2019	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	Part D Exceptions Contact	Chief Financial Officer	Mr	Dodson	David						1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active	1-814-535-6000	22102			PACE - Nat		C	Philadelphia
H5902	Pharmacy Network Management Contact			Rowland	Bob		1-724-275-1203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5902	Pharmacy Technical Help Desk Contact			Rowland	Bob							Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active	1-724-275-1203	219			PACE - Nat		C	Philadelphia
H5902	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active					PACE - Nat		C	Philadelphia
H5926	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H5926	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5926	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H5926	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5928	Automated TrOOP Balance Transfer Contact	Senior Manager, Medicare Operations		Halley	Derek		1-818-228-6374					Derek.Halley@blueshieldca.com	6300 Canoga Ave,		Woodland Hills	CA	91367	01/04/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Best Available Evidence Contact	Manager, Medicare Operations		Loreto	Alfonso		1-818-228-7005					Alfonso.Loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Chief Financial Officer	Senior Director, Medicare Finance	Mr.	Ballou	Taylor		1-818-228-6697					Taylor.Ballou@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		1-818-228-2651					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Coordination of Benefits Contact	Manager, Medicare Operations		Loreto	Alfonso		1-818-228-7005					alfonso.loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Customer Service Operations Contact	Operations Specialist, Consultant		Lopez	Cynthia		1-818-228-6251					Cynthia.Lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Government Relations Contact	Senior Manager, Medicare Compliance		Mata	Marcos		1-818-228-6048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Hospice Contact	Senior Program Manager		Fields	Torrie		1-415-229-5839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	02/12/2018	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		1-818-228-7028					Richard.Robinson@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Part D Exceptions Contact	Director, Pharmacy Prior Authorization		March	Nancee							nancee.march@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	1-800-776-4466				HMO - Health Maintenance Organization		C	San Francisco
H5928	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		1-510-607-2901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5928	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	1-888-970-0933				HMO - Health Maintenance Organization		C	San Francisco
H5928	Plan to Plan Reconciliation Contact	Financial Analyst Consultant		Dahl	Chris		1-818-228-2575					BSCP2PRecon@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5932	Automated TrOOP Balance Transfer Contact	VP, Pharmacy	Mr.	Yarnell	Eric		1-412-918-8830					EYarnell@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222-1202	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Best Available Evidence Contact	Senior Director,Operations	Ms.	Magliocco	Michelle		1-412-255-4810					mmagliocco@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Chief Financial Officer	SVP, Chief Financial Officer	Mr.	Bridges	Ja'Ron		1-412-255-4162					jbridges@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	CMS Casework Communication Contact	Director, Appeals & Grievances	Ms.	McKinney	Lisa		1-412-255-4604					lmckinney@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Coordination of Benefits Contact	Sr. Director, Operations	Ms.	Magliocco	Michelle		1-412-255-4810					COB-TPLMedicare@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	07/15/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Customer Service Operations Contact	Manager Business Operations	Mr.	Hartman	Josh		1-800-685-5209					jhartman@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Government Relations Contact	VP,  Compliance	Mr.	Bissey	Bret		1-412-255-1144					BBissey@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Hospice Contact	Supervisor, Pharmacy Call Center	Mr.	Woods	Shane		1-412-918-8763					SWoods2@highmarkwholecare.com	444 Liberty Ave.	Suite 2100	Pittsburgh	PA	15222	07/15/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Arthurs Peck	Dawn		1-412-918-8771					darthurspeck@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Part D Exceptions Contact	VP, Pharmacy	Mr.	Yarnell	Eric						1-888-245-2049	EYarnell@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active	1-412-918-8830				HMO - Health Maintenance Organization		C	Philadelphia
H5932	Pharmacy Network Management Contact	Pharmacy Product Director	Ms.	Lawson	Jessica		1-412-255-4574					jlawson@highmarkwholecare.com	Four Gateway Center	444 Liberty Ave, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5932	Pharmacy Technical Help Desk Contact			Health Plan	Gateway								Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/19/2018	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active	1-800-685-5209				HMO - Health Maintenance Organization		C	Philadelphia
H5932	Plan to Plan Reconciliation Contact	Sr Financial Analyst	Ms.	Trautvetter	Jill		1-412-255-7132					jtrautvetter@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2023	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H5934	Automated TrOOP Balance Transfer Contact			Galaida	Lisa		1-239-985-6405					lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	Best Available Evidence Contact			Galaida	Lisa		1-239-985-6405					lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	Chief Financial Officer	CFO	Ms.	Lampley	Jill	S	1-239-482-4673				1-239-482-7298	jill.lampley@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33908	02/01/2008	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	CMS Casework Communication Contact			Galaida	Lisa		1-239-985-6405					lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	Coordination of Benefits Contact			Galaida	Lisa		1-239-985-6405					lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	Customer Service Operations Contact			Galaida	Lisa		1-239-985-6405					lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	Government Relations Contact			Galaida	Lisa		1-239-985-6405					lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	Medicare Compliance Officer	Manager, Quality	Ms.	Galaida	Lisa		1-239-985-6406				1-239-985-6411	Lisa.Galaida@hopehcs.org	2668 Winkler Avenue		Ft. Myers	FL	33901	03/03/2021	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part D Exceptions Contact			Galaida	Lisa							lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active	1-866-659-7223				PACE - Nat		C	Atlanta
H5934	Pharmacy Network Management Contact			Galaida	Lisa		1-239-985-6405					lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5934	Pharmacy Technical Help Desk Contact			Galaida	Lisa							lisa.galaida@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/17/2022	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active	1-866-659-7223				PACE - Nat		C	Atlanta
H5934	Plan to Plan Reconciliation Contact		Mr.	Iffland	Bill		1-239-985-7767					bill.iffland@hopehcs.org	9470 HealthPark Circle		Fort Myers	FL	33908	03/03/2017	2023	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Hope Hospice and Community Services, Inc.	283	Yes	Active					PACE - Nat		C	Atlanta
H5937	Automated TrOOP Balance Transfer Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	08/16/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Best Available Evidence Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					mjohnson4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/16/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Chief Financial Officer	SVP and Chief Financial Officer	Ms.	Monsrud	Beth		1-612-676-3217				1-612-676-6501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/11/2016	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	CMS Casework Communication Contact	A&G Regulatory and Compliance Specialist		Wood	Nakia		1-612-294-5668					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Coordination of Benefits Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Customer Service Operations Contact	CS Support Services Sr Manager		Vang	Pakou		1-612-676-3585					pvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Government Relations Contact	Federal Government Relations Specialist		Vang	Julie		1-612-294-5654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/30/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Hospice Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051					pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	McMahon	Jane		1-612-456-7817					federalgrleadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	07/27/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Exceptions Contact	Vice President Pharmacy Management		Mitsch	Patrick						1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	1-612-294-5051				HMO - Health Maintenance Organization		C	Chicago
H5937	Pharmacy Network Management Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Pharmacy Technical Help Desk Contact	Director, Customer Service		Warren	Mark							mwarren@express-scripts.com	6625 West 78th Street		Minneapolis	MN	55439	11/30/2020	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H5937	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		1-612-676-3213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/11/2016	2023	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5938	Automated TrOOP Balance Transfer Contact	Director, PBM Operations	Mrs.	allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	12/30/2022	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Best Available Evidence Contact	Enrollment Director	Ms.	Iscrupe	Catherine		1-850-383-3502				1-850-383-3590	caiscrupe@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Chief Financial Officer	Executive  Vice President, Finance & CFO	Mr.	Bass	Sabin	C	1-850-523-7326				1-850-383-3441	scbass@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/04/2019	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	CMS Casework Communication Contact	Director, Member Services	Ms.	Mackey	Felecia		1-850-523-7302				1-850-383-3339	ffmackey@chp.org	PO Box 15349		Tallahassee	FL	32317	08/15/2011	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Coordination of Benefits Contact	Director, PBM Operations	Mrs.	Allie	Cindy		1-612-777-6722				1-612-777-6706	cobmedd@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	12/30/2022	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Customer Service Operations Contact	Director, Member Services	Ms.	Mackey	Felecia		1-850-383-3311				1-850-383-3338	ffmackey@chp.org	P.O. Box 15349		Tallahassee	FL	32317	12/05/2019	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Government Relations Contact	President and Chief Executive Officer	Mr.	Hogan	John		1-850-383-3492				1-850-383-3497	jmhogan@chp.org	P.O. Box 15349		Tallahassee	FL	32317	04/13/2009	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Hospice Contact	Manager Medication Management Services	Mrs.	Duncan	Anne	A	1-850-523-5648				1-850-383-3413	amduncan@chp.org	PO BOX 15349		Tallahassee	FL	32317	12/30/2021	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Medicare Compliance Officer	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	1-850-523-7304				1-850-523-7419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Part D Exceptions Contact	Regulatory Director		Davis	Megan						1-800-693-6703	Clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2021	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Atlanta
H5938	Pharmacy Network Management Contact	VP Network  Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	12/30/2021	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5938	Pharmacy Technical Help Desk Contact	Director Member Services	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC 2900 Ames Crossing Road		Eagan	MN	55121	12/30/2021	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	1-866-590-3010				HMO - Health Maintenance Organization		C	Atlanta
H5938	Plan to Plan Reconciliation Contact	Actuarial Services Manager	Mr	Jones	David	D	1-850-523-7481				1-850-383-3441	ddjones@chp.org	P.O. 15349		Tallahassee	FL	32317	03/03/2021	2023	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5943	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations and Formulary		Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Best Available Evidence Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		1-562-637-1234				1-562-989-5243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/28/2019	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Chief Financial Officer	Chief Financial Officer	Mr	Plumb	Michael		1-562-997-1589					MPlumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/02/2020	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	CMS Casework Communication Contact	Director, Reg Audit & Ent Mntrng		Cordova	Elizabeth		1-562-997-3131	3131			1-562-989-5120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/18/2022	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Coordination of Benefits Contact	Director, Pharmacy Operations and Formulary	Ms.	Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/03/2022	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		1-562-997-1805				1-562-989-5181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/27/2014	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Government Relations Contact	Sr. Vice President, Public & Government Affairs		Morrell	Adrienne		1-202-349-9008				1-562-989-9439	amorrell@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/12/2019	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Hospice Contact	Manager, Pharmacy Experience and Access	Mr.	Tran	Tri		1-562-308-2884				1-562-997-3196	TMTran@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	02/09/2022	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Medicare Compliance Officer	Compliance Officer	Ms.	Hawkins	Ginette		1-562-308-1195					GHawkins@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/16/2019	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Part D Exceptions Contact	Senior Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	San Francisco
H5943	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	07/03/2018	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5943	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy	STE 150	Temple Terrace	FL	33637	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	San Francisco
H5943	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		1-562-989-8300				1-562-989-0101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/09/2019	2023	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Manosca	Nova		1-858-790-5873					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/31/2016	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Best Available Evidence Contact	Chief Operating Officer	Mr.	Koltz	Patrick		1-775-770-9240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	03/08/2022	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Chief Financial Officer	Director of Finance	Mrs.	Martin	Rachel		1-775-770-1518					rachel.martin@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	10/25/2021	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	CMS Casework Communication Contact	Manager of Compliance & Risk Management	Mrs.	Ballard-Martenies	Kerri	L	1-775-225-3334					kerri.ballard-martenies@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	03/08/2022	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Coordination of Benefits Contact	Chief Operating Officer	Mr.	Koltz	Patrick		1-775-770-9240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	03/08/2022	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Customer Service Operations Contact	Chief Operating Officer		Koltz	Patrick		1-775-770-9240					patrick.koltz@uhsinc.com	1510 Meadow Wood Ln		Reno	NV	89502	03/08/2022	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Government Relations Contact	Chief Compliance Officer	Mr.	Ramirez	Philip		1-775-770-9348					philip.ramirez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	04/16/2020	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Hospice Contact	Health Services Director		Estipona	Steve		1-775-770-9462					Steve.Estipona@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	01/31/2018	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Ramirez	Philip		1-775-770-9348					philip.ramirez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	07/31/2018	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Part D Exceptions Contact	Manager, QA & Client Services		Nguyen	Quan							Quan.nguyen@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	03/28/2020	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	1-858-790-7151				HMO - Health Maintenance Organization		C	San Francisco
H5945	Pharmacy Network Management Contact	Director, Configuration Services		Lujan	Jennifer		1-858-790-6565					jennifer.lujan@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	11/20/2017	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5945	Pharmacy Technical Help Desk Contact	Direct Contact Center Services		Battle	Dorry							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/22/2017	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	1-844-587-7389				HMO - Health Maintenance Organization		C	San Francisco
H5945	Plan to Plan Reconciliation Contact	Manager of Finance	Mr.	Lopez	Robert		1-775-770-9374					Robert.lopez3@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/01/2022	2023	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5959	Automated TrOOP Balance Transfer Contact	Director, PBM Operations		Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/21/2022	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Best Available Evidence Contact	Manager, Business Services		Daniels	Cassandra		1-651-662-3468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/03/2022	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Chief Financial Officer	Senior Vice President, Chief Financial Officer	Mr.	Uribe	John		1-651-662-9501					John.Uribe@bluecrossmn.com	1800 Yankee Doodle Road		Eagan	MN	55121	06/03/2022	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	CMS Casework Communication Contact	Manager Consumer Service Center		Brown	Robyn		1-651-662-7446					robyn.brown@bluecrossmn.com	1800 Yankee Doodle Road		Eagan	MN	55121	07/17/2019	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Coordination of Benefits Contact	Business Services  Mgr		Daniels	Cassandra		1-651-662-3468					government.program.service.request@bcbsmn.com	3400 Yankee Dr		Eagan	MN	55122	06/27/2022	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Customer Service Operations Contact	Director, Business Transformation		Hovick	Denise		1-651-662-8864					denise.hovick@bluecrossmn.com	3535 Blue Cross Road		Eagan	MN	55122	04/21/2022	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Government Relations Contact	VP Public Affairs		Keefer	Scott		1-651-662-8786					scott.keefer@bluecrossmn.com	3535 Blue Cross Road		Eagan	MN	55121	12/13/2021	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Hospice Contact	Operations Business Analyst		Dick	Beth		1-651-662-9644					beth.dick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/19/2019	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Medicare Compliance Officer	Government Compliance Officer	Ms.	Hogan	Carrie		1-651-662-1900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Part D Exceptions Contact	Med D Coverage		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/31/2021	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active	1-800-693-6651				PPO - BBA		C	Chicago
H5959	Pharmacy Network Management Contact	AVP, Network Mangement		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/31/2021	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Pharmacy Technical Help Desk Contact	Director, Member Services		Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	06/30/2021	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active	1-800-648-2778				PPO - BBA		C	Chicago
H5959	Plan to Plan Reconciliation Contact	Manager, Financial Reporting		Harrelson	Michael		1-651-662-8490				1-651-662-2200	Michael.Harrelson@bluecrossmn.com	3535 Blue Cross Rd		Eagan	MN	55122	01/29/2018	2023	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5965	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Coordination of Benefits Contact	Sr. Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H5965	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5965	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H5965	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H5969	Automated TrOOP Balance Transfer Contact	Enrollment Manager	Ms.	Brown	Virginia		1-808-973-7535					vbrown@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	04/26/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Best Available Evidence Contact	Enrollment Manager	Ms	Brown	Virginia		1-808-973-7535				1-808-973-7373	vbrown@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Chief Financial Officer	Chief Financial Officer	Mr.	Field	David		1-808-973-6347				1-808-973-2625	dfield@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	CMS Casework Communication Contact	Compliance Officer	Ms.	Mellor	June		1-808-973-0690				1-808-973-7410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Coordination of Benefits Contact	Enrollment Manager	Ms	Brown	Virginia		1-808-973-7535				1-808-973-7373	vbrown@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Customer Service Operations Contact	Director of Plan Operations	Mr.	Janicek	Jerome		1-808-973-6320				1-808-973-3810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Government Relations Contact	Chief Customer Officer	Ms	Arcena	Paula		1-808-973-6426				1-808-973-0204	parcena@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Hospice Contact	Pharmacy Director	Ms.	Bannister	Hanh		1-808-973-6843				1-808-973-6327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Medicare Compliance Officer	Compliance Officer	Ms.	Mellor	June		1-808-973-0690				1-808-973-7410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Part D Exceptions Contact	Pharmacy Director	Ms.	Bannister	Hanh						1-808-973-6327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active	1-866-973-7418				HMO - Health Maintenance Organization		C	San Francisco
H5969	Pharmacy Network Management Contact	Pharmacy Director	Ms.	Bannister	Hanh		1-808-973-6843				1-808-973-6327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5969	Pharmacy Technical Help Desk Contact	Director Pharmacy Management	Mr.	Warner	Raymond							Raymond.Warner@Ingenio-RX.com	21215 Burkbank Blvd		Woodland Hills	CA	91367	04/26/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	San Francisco
H5969	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Field	David		1-808-973-6347				1-808-973-2625	dfield@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2023	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H5970	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H5970	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H5970	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5978	Automated TrOOP Balance Transfer Contact	NA	Mr.	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	Best Available Evidence Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	Chief Financial Officer	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	CMS Casework Communication Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	Coordination of Benefits Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	Customer Service Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	Government Relations Contact	Chief Executive Officer	Mr	Irwin	Mark		1-814-535-6000	22101			1-814-248-7902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	Medicare Compliance Officer	Executive Director	Mr	Sauers	Robert		1-610-954-5433	31167				RSauers@SeniorLifeLehighValley.com	3365 High Point Boulevard		Bethlehem	PA	18017	06/24/2020	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	Part D Exceptions Contact	Chief Financial Officer	Mr	Dodson	David						1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active	1-814-535-6000	22102			PACE - Nat		C	Philadelphia
H5978	Pharmacy Network Management Contact			Rowland	Bob		1-724-275-1203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5978	Pharmacy Technical Help Desk Contact			Rowland	Bob							Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active	1-724-275-1203	219			PACE - Nat		C	Philadelphia
H5978	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		1-814-535-6000	22102			1-814-248-7902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2023	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active					PACE - Nat		C	Philadelphia
H5989	Automated TrOOP Balance Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Best Available Evidence Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Chief Financial Officer	Chief Financial Officer	Mr.	Bermel	John		1-212-479-2777					jbermel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	CMS Casework Communication Contact	Complaints Manager	Ms.	Gabriel	Charisse		1-646-767-5697					cgabriel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Coordination of Benefits Contact	Director, Payment Integrity Team	Ms.	Hutchinson	Chris		1-917-698-2415					chutchinson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Customer Service Operations Contact	VP,  Member Services	Ms.	O'Connor	Kimberly		1-212-801-1639					koconnor@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Government Relations Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		1-646-313-8967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Hospice Contact	Director, Pharmacy Operations	Ms.	Lee Brown	Hannah		1-646-429-3818					hleebrown@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Medicare Compliance Officer	Chief Compliance Officer & Head of Internal Audit	Mr.	Hackendorn	John		1-212-453-4495					jhackendorn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Part D Exceptions Contact	Director, Pharmacy Operations	Ms.	Lee Brown	Hannah							hleebrown@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	1-888-260-1010				HMO - Health Maintenance Organization		C	New York
H5989	Pharmacy Network Management Contact	Director, Pharmacy Operations	Mr.	Suri	Tarun		1-646-354-1168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5989	Pharmacy Technical Help Desk Contact	Director, Client Operations	Ms.	Dayoub	Joselyn							dayoubj@cvshealth.com	CVS Health	800 NW Chipman Rd, Ste 5830	Lees Summit	MO	64063	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H5989	Plan to Plan Reconciliation Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor	Attn:  Treasury Department	New York	NY	10007	11/08/2022	2023	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		1-860-674-5780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	06/25/2021	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Best Available Evidence Contact	Manager, Vendor Operations		Ewen	Jillian		1-860-674-5780					jewen@connecticare.com	175 Scott Swamp Road	P.O. Box 4050	Farmington	CT	06034-4050	03/23/2020	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		1-646-447-6174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	07/02/2020	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	CMS Casework Communication Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	1-646-447-7215				1-212-510-8130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	07/25/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Coordination of Benefits Contact	Sr. Dir., Claims Operations & Provider Data Mgmt		Gauthier	Kathleen	H	1-860-409-6435					kgauthier@connecticare.com	55 Water Street		New York	NY	10041	07/15/2021	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Customer Service Operations Contact	VP, Ops Strategy & Service Delivery		Pandey	Priyank		1-646-447-7543					ppandey@emblemhealth.com	55 Water Street		New York	NY	10041	02/17/2021	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Government Relations Contact	Director, Medicare Compliance		Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/09/2019	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Hospice Contact	Senior Medicare Pharmacy Specialist		Der Weer	J'Nisha		1-646-447-7198					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/08/2019	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Exceptions Contact	Director		Colby	Andrew							acolby@emblemhealth.com	55 Water street		New York	NY	10041	05/12/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	1-646-447-3340				HMO - Health Maintenance Organization		C	New York
H5991	Pharmacy Network Management Contact	Pharmacy Client Ops Director		Brown	Gregory		1-401-525-1683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	6625 West 78th street		Bloomington	MN	55439	01/24/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	1-800-922-1557	2			HMO - Health Maintenance Organization		C	New York
H5991	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		1-646-447-3017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	08/16/2022	2023	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth Medicare HMO	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/14/2021	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H5992	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H5992	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5993	Automated TrOOP Balance Transfer Contact	COO	Mr.	Wildt	Jonathan		1-872-588-3014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	Best Available Evidence Contact	COO	Mr.	Wildt	Jonathan		1-872-588-3014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	Chief Financial Officer	CFO	Mr.	Dons	Chris		1-872-588-3032					christopherdons@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	CMS Casework Communication Contact	COO	Mr.	Wildt	Jonathan		1-872-588-3014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	Coordination of Benefits Contact	COO	Mr.	Wildt	Jonathan		1-872-588-3014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	Customer Service Operations Contact	COO	Mr.	Wildt	Jonathan		1-872-588-3014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	Government Relations Contact			Sianghio	Alyssa		1-872-588-3015					development@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	Medicare Compliance Officer	COO	Mr.	Wildt	Jonathan		1-872-588-3014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	Part D Exceptions Contact			Wildt	Jonathan							PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending	1-872-588-3000				PACE - Nat		C	Chicago
H5993	Pharmacy Network Management Contact	COO	Mr.	Wildt	Jonathan		1-872-588-3014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5993	Pharmacy Technical Help Desk Contact			Shah	Chris							pace@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending	1-872-588-3000				PACE - Nat		C	Chicago
H5993	Plan to Plan Reconciliation Contact	COO	Mr.	Wildt	Jonathan		1-872-588-3014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2023	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H5995	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		1-858-790-6445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Best Available Evidence Contact	Enrollment Manager		Vredenburg	Cristi		1-541-492-5119					Cristi.vredenburg@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	08/04/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Chief Financial Officer	Chief Financial Officer	Mr.	Desai	Roshan		1-727-251-8934				1-503-584-1772	Roshan.Desai@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	05/18/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	CMS Casework Communication Contact	Enrollment Manager		Vredenburg	Cristi		1-541-492-5119					Cristi.vredenburg@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	08/04/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Coordination of Benefits Contact	Chief Operations Officer	Ms.	Regalado	Mae		1-951-206-7316					mae.regalado@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	03/04/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Customer Service Operations Contact	Chief Operations Officer	Ms.	Regalado	Mae		1-951-206-7316					mae.regalado@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	03/04/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Government Relations Contact	Chief Compliance Officer		Flynn	Jordan		1-602-692-4381				1-503-584-1772	Jordan.flynn@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	07/08/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Hospice Contact	VP of Pharmacy Operations	Ms.	Liu	Helen		1-970-712-9377					helen.liu@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	12/08/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Flynn	Jordan		1-602-692-4381				1-503-584-1772	Jordan.flynn@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	07/08/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Part D Exceptions Contact	Director of Appeals and Grievances		Vaughn	Sara						1-541-672-8670	sara.vaughn@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	11/11/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	1-877-672-8620	3			HMO - Health Maintenance Organization		C	Seattle
H5995	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/13/2019	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H5995	Pharmacy Technical Help Desk Contact	Director, Contact Center Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/08/2018	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	1-800-681-9571				HMO - Health Maintenance Organization		C	Seattle
H5995	Plan to Plan Reconciliation Contact	Chief Financial Officer		Desai	Roshan		1-727-251-8934				1-503-584-1772	Roshan.Desai@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	05/18/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6018	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H6018	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6018	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H6018	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6019	Automated TrOOP Balance Transfer Contact	Medicare Front End Process Manager		Platts	Karen		1-816-843-5486					585HPSM@argushealth.com	423 W. 8th Street		Kansas City	MO	64105	02/02/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Best Available Evidence Contact	CareAdvantage Manager		Barairo	Charlene		1-650-616-2183					CMSEnrollmentCenter@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Chief Financial Officer	Chief Financial Officer	Mr.	Ehrgood	Trent		1-650-616-2171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	CMS Casework Communication Contact	Director of Medicare		Rosado-Torres	Karla		1-650-616-5027					Karla.Rosado-Torres@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	08/25/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Coordination of Benefits Contact	Chief Information Officer	Mr.	Yong	Eben		1-650-616-2010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Customer Service Operations Contact	Director of Medicare		Rosado-Torres	Karla		1-650-616-5027					Karla.Rosado-Torres@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	08/25/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Government Relations Contact	Director of Compliance		Armenta	Brandy		1-650-616-1505					brandy.armenta@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	11/21/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Hospice Contact	CareAdvantage Manager		Barairo	Charlene		1-650-616-2183					CMSEnrollmentCenter@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Medicare Compliance Officer	Chief Compliance Officer	Mr	Johansson	Ian	K	1-650-616-2151					ian.johansson@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	02/02/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Part D Exceptions Contact			Services	Pharmacy							PharmPA@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active	1-650-616-2088				HMO - Health Maintenance Organization		C	San Francisco
H6019	Pharmacy Network Management Contact	Credentialing Specialist		Dela Cruz	Paul		1-650-616-2107					CMSPharmacyNetwork@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6019	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy						1-816-283-9785	help@argushealth.com	1300 Washington Street		Kansas City	MO	64105	02/03/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active	1-888-635-8362				HMO - Health Maintenance Organization		C	San Francisco
H6019	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Ehrgood	Trent		1-650-616-2171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2023	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6053	Chief Financial Officer	Secretary/Treasurer	Mr.	Richardson	Don	C	1-626-967-3550				1-626-967-3161	morngold@yahoo.com	551 E. San Bernardino Road,		Covina	CA	91723	09/09/2009	2023	SANTE FE EMPLOYEES HOSPITAL ASSOCIATION	HCPP - 1833 Cost	Santa Fe Employes Hospital Assn. - Coast Lines	HCPP - 1833 Cost		Sante Fe Employees Hospital Assn.	202	No	Active					HCPP		1	San Francisco
H6053	CMS Casework Communication Contact	CEO	Mr.	Philippi	Larry	D	1-877-968-3550				1-626-967-3161	larrydphilippi@gmail.com	551 E. San Bernardino Road,		Covina	CA	91723	09/27/2021	2023	SANTE FE EMPLOYEES HOSPITAL ASSOCIATION	HCPP - 1833 Cost	Santa Fe Employes Hospital Assn. - Coast Lines	HCPP - 1833 Cost		Sante Fe Employees Hospital Assn.	202	No	Active					HCPP		1	San Francisco
H6053	Customer Service Operations Contact	CEO	Mr.	Philippi	Larry	D	1-877-968-3550				1-626-967-3161	larrydphilippi@gmail.com	551 E. San Bernardino Road,		Covina	CA	91723	09/27/2021	2023	SANTE FE EMPLOYEES HOSPITAL ASSOCIATION	HCPP - 1833 Cost	Santa Fe Employes Hospital Assn. - Coast Lines	HCPP - 1833 Cost		Sante Fe Employees Hospital Assn.	202	No	Active					HCPP		1	San Francisco
H6053	Government Relations Contact	CEO	Mr.	Philippi	Larry	D	1-877-968-3550				1-626-967-3161	larrydphilippi@gmail.com	551 E. San Bernardino Road,		Covina	CA	91723	09/27/2021	2023	SANTE FE EMPLOYEES HOSPITAL ASSOCIATION	HCPP - 1833 Cost	Santa Fe Employes Hospital Assn. - Coast Lines	HCPP - 1833 Cost		Sante Fe Employees Hospital Assn.	202	No	Active					HCPP		1	San Francisco
H6053	Medicare Compliance Officer	CEO	Mr.	Philippi	Larry	D	1-877-968-3550				1-626-967-3161	larrydphilippi@gmail.com	551 E. San Bernardino Road,		Covina	CA	91723	09/27/2021	2023	SANTE FE EMPLOYEES HOSPITAL ASSOCIATION	HCPP - 1833 Cost	Santa Fe Employes Hospital Assn. - Coast Lines	HCPP - 1833 Cost		Sante Fe Employees Hospital Assn.	202	No	Active					HCPP		1	San Francisco
H6059	Automated TrOOP Balance Transfer Contact	Executive Director		Robinson	Ursula		1-336-550-4040					Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/13/2020	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	Best Available Evidence Contact	Program Director	Mrs	Robinson	Ursula	B	1-336-550-4040				1-336-464-2212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/02/2022	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	Chief Financial Officer	PACE Specialist	Mrs	Richter	Dani		1-336-832-7420				1-336-832-6941	Dani.Richter@conehealth.com	1200 N. Elm Street, Parkview Plaza Suite 1B		Greensboro	NC	27401	08/10/2022	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	CMS Casework Communication Contact	Program Director	Mrs	Robinson	Ursula	B	1-336-550-4040				1-336-464-2212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/02/2022	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	Coordination of Benefits Contact	Executive Director		Robinson	Ursula		1-336-550-4040					Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/13/2020	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	Customer Service Operations Contact	Outreach and Intake Coordinator	Mrs.	Baldwin	Nedra		1-336-550-4040				1-336-550-4044	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/08/2017	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	Government Relations Contact	Program Director	Mrs	Robinson	Ursula	B	1-336-550-4040				1-336-550-4044	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	05/03/2013	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	Medicare Compliance Officer	Director of Quality and Compliance	Mr.	Smith	Adria		1-336-550-4051				1-336-458-5550	Adria.Smith@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	03/02/2022	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	Part D Exceptions Contact	Program Director	Mrs	Robinson	Ursula	B					1-336-550-4044	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/06/2013	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	1-336-550-4040				PACE - Nat		C	Atlanta
H6059	Pharmacy Network Management Contact	Medical Director	Dr	Koehler	Robert		1-336-550-4040				1-336-550-4045	Robert.Koehler@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/02/2022	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6059	Pharmacy Technical Help Desk Contact	Clinical Coordinator	Mrs	Williams	Tina						1-336-550-4045	Tina.Williams@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/02/2022	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	1-336-550-4040				PACE - Nat		C	Atlanta
H6059	Plan to Plan Reconciliation Contact	Health Plan Specialist		Powell	Greg		1-336-550-4040					Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	12/27/2020	2023	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active					PACE - Nat		C	Atlanta
H6062	Automated TrOOP Balance Transfer Contact	VP, Pharmacy		Patel	Monank		1-813-468-3605					monank.patel@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Best Available Evidence Contact	Manager, Eligibility & Enrollment		Rhodes	Trent		1-405-280-5871					trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Chief Financial Officer	Vice President, Finance	Ms.	Harris	Tayla		1-405-280-5724					tayla.harris@globalhealth.com	210 Park Ave	Suite 2800	Oklahoma City	OK	73102	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	CMS Casework Communication Contact	Senior Director, Compliance		Akins	Monique	S	1-405-280-5741					monique.akins@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	12/01/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Coordination of Benefits Contact	Manager, Eligibility & Enrollment		Rhodes	Trent		1-405-280-5871					trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Customer Service Operations Contact	Director, Customer Care		Thomas	Daniel		1-405-280-5626					Daniel.Thomas@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Government Relations Contact	VP, Compliance & Legal		Kabuci	Lauren		1-405-280-5220					lauren.kabuci@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	12/01/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Hospice Contact	VP, Health Services		Stouffer	Kelly		1-405-280-5608					kelly.stouffer@globalhealth.com	6120 S. Yale Avenue	Suite 925	Tulsa	OK	74136	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Medicare Compliance Officer	Senior Director, Compliance	Ms.	Akins	Monique		1-405-280-5741					monique.akins@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Part D Exceptions Contact	VP, Pharmacy		Patel	Monank							monank.patel@globalhealth.com	6120 S Yale Avenue	Suite 925	Tulsa	OK	74136	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	1-813-468-3605				HMO - Health Maintenance Organization		C	New York
H6062	Pharmacy Network Management Contact	VP, Pharmacy		Patel	Monank		1-813-468-3605					monank.patel@globalhealth.com	6120 S Yale Avenue	Suite 925	Tulsa	OK	74136	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6062	Pharmacy Technical Help Desk Contact	VP, Pharmacy		Patel	Monank							monank.patel@globalhealth.com	6120 S Yale Avenue	Suite 925	Tulsa	OK	74136	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H6062	Plan to Plan Reconciliation Contact	VP, Finance		Harris	Tayla		1-405-280-5724					tayla.harris@globalhealth.com	210 Park Avenue	Suite 2800	Oklahoma City	OK	73102-5621	10/26/2022	2023	GLOBALHEALTH OF TEXAS, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6067	Automated TrOOP Balance Transfer Contact	Sr. Reporting Analyst		Carroll	Teri		1-410-998-5022					Teri.Carroll@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/17/2022	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Best Available Evidence Contact	VP Medicare		Billman	Julie		1-410-998-7534					julie.billman@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	09/17/2022	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Chief Financial Officer	Interim CFO/Dir, Financial Plng & Analysis	Mr.	Crippen	Ryan		1-410-998-5459					Ryan.Crippen@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2022	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	CMS Casework Communication Contact	VP, Medicare		Billman	Julie		1-410-998-7534					Julie.Billman@Carefirst.com	10455 Mill Run Circle Mailstop	OWML1 18192	Owings Mills	MD	21117	10/10/2020	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Coordination of Benefits Contact	Director, Medicare Operations	Ms.	Challis	Juanita		1-410-998-7534					CFGroupMA@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	05/31/2022	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Customer Service Operations Contact	VP Medicare		Billman	Julie		1-410-998-7534					julie.billman@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	01/24/2020	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Government Relations Contact	Medicare Compliance Officer		Snapp-Borleis	Mary-Paul		1-410-605-2579					mary-paul.snapp-borleis@carefirst.com	1501 S. Clinton Street	7th Floor	Baltimore	MD	21224	10/10/2020	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Hospice Contact	Director, Health Services	Ms	Baumhardt-Rivera	Cindy		1-410-605-2508					Cindy.Baumhardt-Rivera@carefirst.com	P.O. Box 915		Owing Mills	MD	21117	09/17/2022	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Medicare Compliance Officer	Medicare Compliance Officer		Snapp-Borleis	Mary-Paul		1-410-605-2579					Mary-Paul.Snapp-Borleis@Carefirst.com	1501 S Clinton St		Baltimore	MD	21224	10/10/2020	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Part D Exceptions Contact	Sr. Dir., Pharm Eval & Oversight		Poplawski	Mandi							Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	04/26/2021	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	1-410-528-5053				HMO - Health Maintenance Organization		C	Philadelphia
H6067	Pharmacy Network Management Contact	Director Pharmacy Government Programs		Nardone	Mark		1-410-998-5675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	02/04/2020	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6067	Pharmacy Technical Help Desk Contact	Director Pharmacy Government Programs		Nardone	Mark							Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	01/04/2021	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Philadelphia
H6067	Plan to Plan Reconciliation Contact	Interim CFO/Dir, Financial Plng & Analysis	Mr.	Crippen	Ryan		1-410-998-5459					Ryan.Crippen@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2022	2023	CAREFIRST ADVANTAGE, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6078	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H6078	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H6078	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	Group Retiree Health Solutions, Inc.	Local CCP	Region 6 Rx Corp PPO	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6079	Automated TrOOP Balance Transfer Contact	Director, PACE Finance		Hewitt	Jessica		1-720-974-6767				1-303-996-1600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/15/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-720-289-6171				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/15/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	Chief Financial Officer	CFO	Mrs	Gutierrez	Barbara		1-303-869-4664				1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	03/14/2018	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-804-543-0876				1-303-996-1600	epeak@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	10/01/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-720-974-6031				1-303-996-1600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/27/2020	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	Customer Service Operations Contact	Regional Executive Director		Williams	Jeanette		1-909-677-9517				1-303-996-1600	JWilliams3@myinnovage.com	3870 Rosin Court		Sacramento	CA	95834	04/26/2022	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	Government Relations Contact	Executive VP Government Relations		Steckel	Carol		1-720-789-6157				1-303-996-1600	CSteckel@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/26/2022	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	Medicare Compliance Officer	VP of Pharmacy Services	Mrs.	Chase	Darla		1-720-974-6785				1-303-996-1614	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	Part D Exceptions Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	1-303-869-4664				PACE - Nat		C	San Francisco
H6079	Pharmacy Network Management Contact	VP of Pharmacy Services	Mrs.	Chase	Darla		1-303-869-4664				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6079	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Mrs.	Chase	Darla						1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/17/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	1-303-869-4664				PACE - Nat		C	San Francisco
H6079	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-720-974-6031				1-720-917-3390	akizewski@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	09/15/2021	2023	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	San Francisco
H6080	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/27/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/27/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	09/27/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/27/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	09/27/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	09/27/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	09/27/2022	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				Demo Risk Option C	MMP HMO Demo	C	Chicago
H6080	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/10/2021	2023	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Demo	MeridianComplete	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H6081	Automated TrOOP Balance Transfer Contact			Avila	Valerie		1-909-260-4123					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/22/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	Best Available Evidence Contact			Magana	Vanessa		1-760-475-4753					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/22/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	Chief Financial Officer		MD	Milani	Arash		1-805-698-2795					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/22/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	CMS Casework Communication Contact			Avila	Valerie		1-909-260-4123					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/22/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	Coordination of Benefits Contact			Avila	Valerie		1-909-260-4123					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/23/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	Customer Service Operations Contact			Madrigal-Flynn	Brandy		1-909-228-3127					highdesertpace@gmail.com	12223 Highland Avenue	Suite 106-536	Rancho Cucamonga	CA	91739	06/23/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	Government Relations Contact			Kraft	Sheila		1-760-881-1630					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/23/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	Medicare Compliance Officer	NP	NP	Iglais	Jorge		1-786-287-8675					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/23/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	Part D Exceptions Contact			Pleng	Wendy							highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/23/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending	1-760-981-8469				PACE - Nat		C	San Francisco
H6081	Pharmacy Network Management Contact			Avila	Valerie		1-909-260-4123					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/23/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6081	Pharmacy Technical Help Desk Contact			Pleng	Wendy							highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/23/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending	1-760-981-8469				PACE - Nat		C	San Francisco
H6081	Plan to Plan Reconciliation Contact			Magana	Vanessa		1-760-475-4753					highdesertpace@gmail.com	11833 Amethyst Road		Victorville	CA	92392	06/23/2022	2023	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6142	Chief Financial Officer	CHIEF FINANCIAL OFFICER	Ms.	Vullmahn	Caroline		1-312-423-4200					cvullmahn@unionhealth.org	1634 W POLK ST		CHICAGO	IL	60612	10/06/2022	2023	UNION HEALTH SERVICES, INC.	HCPP - 1833 Cost	Union Health Service, Inc.	HCPP - 1833 Cost		Union Health Services, Inc.	241	No	Active					HCPP		1	Chicago
H6142	Medicare Compliance Officer		MS.	ROCK	JILL		1-312-423-4200	3222				JROCK@UNIONHEALTH.ORG	1634  W POLK STREET		CHICAGO	IL	60612	04/28/2021	2023	UNION HEALTH SERVICES, INC.	HCPP - 1833 Cost	Union Health Service, Inc.	HCPP - 1833 Cost		Union Health Services, Inc.	241	No	Active					HCPP		1	Chicago
H6147	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Gobin	Antony		1-909-558-4000					AGobin@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	Best Available Evidence Contact	VP, Financial Services		Mowery	Lew		1-909-558-4000					lmowery@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	Chief Financial Officer	Chief Financial Officer and SVP Finance	Ms.	Lalas	Angela		1-909-558-4000					ALalas@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	CMS Casework Communication Contact	AVP, Care Coordination		Arias	Paul		1-909-558-4000					PArias@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	Coordination of Benefits Contact	Director, Managed Care Finance		Rusovick	Heather		1-909-558-4000					HRusovick@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	Customer Service Operations Contact	Director-Patient Relations		Mikhail	Wagih		1-909-558-4000					WMikhail@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	Government Relations Contact	Program Executive Director	Ms.	Malqued	Bernadette		1-909-651-4631					bpmalqued@llu.edu	101 East Redlands Boulevard		San Bernardino	CA	92408	09/23/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	Medicare Compliance Officer	Compliance & Privacy Officer	Ms.	Okon	Tonya		1-909-558-4000					TOkon@llu.edu	101 East Redlands Boulevard		San Bernardino	CA	92408	09/23/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	Part D Exceptions Contact	Director-Pharmacy Outpatient, Pharmacy		Smith	Jenise							JEDSmith@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending	1-909-558-4000				PACE - Nat		C	San Francisco
H6147	Pharmacy Network Management Contact	Director-Pharmacy Outpatient, Pharmacy		Smith	Jenise		1-909-558-4000					JEDSmith@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6147	Pharmacy Technical Help Desk Contact	Pharmastar		Service	Customer							jvang@pharmastaronline.com	2503 N. Hillcrest Parkway		Altoona	WI	54720	09/23/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending	1-888-298-7770				PACE - Nat		C	San Francisco
H6147	Plan to Plan Reconciliation Contact	Director, Managed Care Finance		Rusovick	Heather		1-909-558-4000					HRusovick@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2023	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6154	Automated TrOOP Balance Transfer Contact			Bean	Danielle		1-952-992-2864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Best Available Evidence Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Chief Financial Officer		Ms	Quist	Mary		1-952-992-2058					mary.quist@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	CMS Casework Communication Contact			Sikorski	TJ		1-952-992-8542				1-952-992-8492	thomas.sikorski@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/04/2023	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Coordination of Benefits Contact			Vilendrer	Krista		1-952-992-3252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Customer Service Operations Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Government Relations Contact			Kinsella	Ann		1-952-992-3832					ann.kinsella@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/21/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Hospice Contact			Bourdages	Kathy		1-952-992-3653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Medicare Compliance Officer		Mrs	Koranteng	Milly		1-952-992-2090					mildred.koranteng@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/22/2020	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/13/2017	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-952-992-2353				HMO - Health Maintenance Organization		C	Kansas City
H6154	Pharmacy Network Management Contact			Dornbrook-Lavender	Kimberly		1-952-992-3448					kimberly.dornbrook-lavender@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6154	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	La Tasha							LaTasha_Monroe@expressscripts.com	13051 N. Telecom Pkwy		Temple Terrace	FL	33637	11/17/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Kansas City
H6154	Plan to Plan Reconciliation Contact			Cameron	Andrew		1-952-992-2386					Andrew.Cameron@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	11/12/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6158	Automated TrOOP Balance Transfer Contact	Eligibility Supervisor		White	William		1-612-777-6736					eobp2p@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	02/05/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Best Available Evidence Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Chief Financial Officer	CFO	Mr.	Winter	Scott		1-501-399-3951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/05/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	CMS Casework Communication Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Coordination of Benefits Contact	Eligibility Supervisor		White	William		1-612-777-6736					cobmedd@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	02/05/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Customer Service Operations Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Government Relations Contact	Sr Counsel Gov't Relation		Fenton	Janie		1-501-378-2103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/05/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		1-501-378-3743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Fenske	Anjenette		1-501-244-6350					amfenske@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/10/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Part D Exceptions Contact			Review Audit & Regul	Clinical						1-800-693-6703	clinicalreviewclientinquiries@primetherapeutics.co	Centennial Crossings - Clinical Review 4401 West 76th S		Edina	MN	55435	02/05/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Dallas
H6158	Pharmacy Network Management Contact	Senior Director Network Provider Relations		Grindsteinner	Bretta		1-612-777-4021					bgrinsteinner@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	02/05/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	Prime						1-888-285-2242	MGarzarodriguez@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	02/05/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	1-800-693-3815				HMO - Health Maintenance Organization		C	Dallas
H6158	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		1-501-399-3958				1-501-378-3258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	02/05/2020	2023	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6188	Automated TrOOP Balance Transfer Contact	Director Financial Management	Mr.	Hamm	David		1-724-776-1100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/23/2022	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Best Available Evidence Contact	Director Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Chief Financial Officer	CFO	Mr.	Carraway	Jeffrey		1-724-776-1100					jeffrey.carraway@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	02/02/2018	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	CMS Casework Communication Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Coordination of Benefits Contact	Director Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Customer Service Operations Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Government Relations Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Medicare Compliance Officer	Director Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Part D Exceptions Contact	Director Financial Management	Mr.	Hamm	David							dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active	1-724-742-2226				PACE - Nat		C	Philadelphia
H6188	Pharmacy Network Management Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Konitzky	Paul						1-724-543-4370	paul.konitzky@lutheranseniorlife.org	115 Nolte Drive		Kittanning	PA	16201	03/10/2020	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active	1-724-545-8000				PACE - Nat		C	Philadelphia
H6188	Plan to Plan Reconciliation Contact	Director Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2023	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6193	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H6193	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6193	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H6193	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6200	Automated TrOOP Balance Transfer Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Best Available Evidence Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Chief Financial Officer	Chief Financial Officer	Mr.	Grabski	Ben		1-763-300-7611					bgrabski@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	CMS Casework Communication Contact	Sr. Director Compliance	Mr.	Whitbeck	Britton		1-314-209-3989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Coordination of Benefits Contact			Inquiries	COB		1-866-597-9560					COBInquiry@lumeris.com	P O BOX 5907		TROY	MI	48007	12/06/2022	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoffer	Linda		1-636-686-9682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		1-314-209-2717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Hospice Contact	Director, Pharmacy		Cruz	Jennifer		1-314-770-3556					pharmacy@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Medicare Compliance Officer	VP Internal Audit and Chief Compliance Officer	Ms.	Venable	Erin		1-314-209-3957					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Part D Exceptions Contact		Ms.	Byers	June							June.Byers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				PPO - BBA		C	Kansas City
H6200	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6200	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				PPO - BBA		C	Kansas City
H6200	Plan to Plan Reconciliation Contact	Manager, Client Payments		Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H6202	Automated TrOOP Balance Transfer Contact	Sr. Project Manager		Rush	Jamie		1-314-354-1103					ESITroopTransfer@express-scripts.com	One Express Way		St.Louis	MO	63121	02/04/2020	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Best Available Evidence Contact	Manager, Enrollment and Billing		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road Suite 200		Glen Allen	VA	23060	04/27/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Chief Financial Officer	SVP, Controller	Mr.	Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	CMS Casework Communication Contact	Compliance Consultant		White	Jasmin		1-248-665-4235					JWhite4@bcbsm.com	1000 Town Center		Southfield	MI	48075	02/06/2020	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Coordination of Benefits Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	03/22/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Customer Service Operations Contact	Director, Workforce Management, Analytics, & Supp		Weber	Julie		1-313-225-0555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/11/2021	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Government Relations Contact	Manager, Performance and Oversight		Martell	Stacey		1-313-806-5905					smartell@bcbsm.com	1000 Town Center		Southfield	MI	48075	04/16/2020	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Hospice Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		1-954-498-5880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	02/06/2020	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-614-336-3326				PPO - BBA		C	Chicago
H6202	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St.Louis	MO	63121	07/06/2021	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6202	Pharmacy Technical Help Desk Contact	Director of Operations, Contact Center		Liu	Ian							iliu@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	02/06/2020	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H6202	Plan to Plan Reconciliation Contact	SVP, Controller		Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	Local CCP	NextBlue of North Dakota	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6231	Automated TrOOP Balance Transfer Contact	Director of Finance	Mr.	Blanchard	John	W	1-225-490-0324				1-225-490-0354	John.Blanchard@fmolhs.org	7436 Bishop Ott Drive	4200  Essen Lane	Baton Rouge	LA	70806	03/13/2009	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	Best Available Evidence Contact	Franciscan PACE, Inc. Senior Director	Mrs.	Taylor	Wendy		1-225-490-0604	322			1-225-490-0354	wendy.taylor@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	11/19/2019	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	Chief Financial Officer	Chief Financial Officer - FMOLHS	Mr.	Ramsey	Robert		1-225-923-2701				1-225-926-4846	robert.ramsey@fmolhs.org	4200 Essen Lane		Baton Rouge	LA	70808	08/22/2022	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	CMS Casework Communication Contact	Executive Director	Ms.	Allen	Karen		1-225-490-0322				1-225-490-0354	karen.allen@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	03/13/2009	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	Coordination of Benefits Contact	Director of Finance	Mr.	Blanchard	John	W	1-225-490-0324				1-225-490-0354	John.Blanchard@fmolhs.org	7436 Bishop Ott Drive	4200  Essen Lane	Baton Rouge	LA	70806	03/13/2009	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	Customer Service Operations Contact	Franciscan PACE Inc. Senior Director	Mrs.	Taylor	Wendy		1-225-490-0604	322			1-225-490-0354	wendy.taylor@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	11/19/2019	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	Government Relations Contact	Executive Director	Ms.	Allen	Karen		1-225-490-0322				1-225-490-0354	karen.allen@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	03/13/2009	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	Medicare Compliance Officer	Compliance Officer	Mr.	Leblanc	Philip		1-225-765-5216				1-225-490-0354	Philip.leblanc@fmolhs.org	5000 Hennessy Blvd.		Baton Rouge	LA	70809	02/02/2015	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	Part D Exceptions Contact	Franciscan PACE Inc. Medical Director	Dr.	Green	Michael						1-225-490-0354	michael.green@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	12/27/2018	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active	1-800-789-2863				PACE - Nat		C	Denver
H6231	Pharmacy Network Management Contact	Franciscan PACE Inc. Senior Director	Mrs.	Taylor	Wendy		1-225-490-0604	322			1-225-490-0354	wendy.taylor@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	11/19/2019	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6231	Pharmacy Technical Help Desk Contact	Center Manager	Mrs.	Mitchell	Felicity						1-225-490-0354	felicity.mitchell@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/09/2022	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active	1-225-490-0604				PACE - Nat		C	Denver
H6231	Plan to Plan Reconciliation Contact	Director of Finance	Mr.	Blanchard	John	W	1-225-490-0324				1-225-490-0354	John.Blanchard@fmolhs.org	7436 Bishop Ott Drive	4200  Essen Lane	Baton Rouge	LA	70806	03/13/2009	2023	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	Denver
H6237	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				HMO - Health Maintenance Organization		C	Seattle
H6237	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6237	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				HMO - Health Maintenance Organization		C	Seattle
H6237	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H6306	Automated TrOOP Balance Transfer Contact	VP, Chief Compliance Officer	Ms.	Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@Healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Best Available Evidence Contact	Manager of Pharmacy Services	Ms.	Lukow	Christine		1-910-687-6569				1-910-687-6506	Christine.Lukow@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	01/11/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Chief Financial Officer	Chief Financial Officer	Mr.	Bradford	Jerry		1-217-902-9002				1-217-902-9740	Jerry.Bradford@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	10/29/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	CMS Casework Communication Contact	Manager of Regulatory and Medicare Compliance	Ms	Russell	Petrina		1-910-687-6560				1-910-687-6506	Petrina.Russell@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Coordination of Benefits Contact	Medicare Operations Manager		Rentmeester	Kurt		1-910-687-6629				1-910-687-6506	Kurt.Rentmeester@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	01/11/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Customer Service Operations Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Government Relations Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9740	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Hospice Contact	Manager of Pharmacy	Ms.	Lukow	Christine		1-217-902-8224				1-217-902-9794	christine.lukow@firstcarolinacare.com	42 Memorial Dr.		Pinehurst	NC	28374	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Medicare Compliance Officer	VP, Chief Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224					hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Part D Exceptions Contact	Manager of Pharmacy Services	Ms.	Lukow	Christine						1-910-687-6506	Christine.Lukow@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	01/11/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active	1-910-687-6569				HMO - Health Maintenance Organization		C	Chicago
H6306	Pharmacy Network Management Contact	VP, Chief Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224					hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6306	Pharmacy Technical Help Desk Contact	Manager of Pharmacy	Ms.	Lukow	Christine						1-217-902-9794	christine.lukow@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	01/18/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active	1-800-880-1188	2			HMO - Health Maintenance Organization		C	Chicago
H6306	Plan to Plan Reconciliation Contact	Finance Manager-Risk Adjustment		Tizora	Elizabeth		1-217-902-9469					elizabeth.tizora@healthalliance.org	3310 Fields South Drive		Champaign,	IL	61822	11/16/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	HMO/HMOPOS		The Carle Foundation	583	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H6316	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H6316	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6317	Automated TrOOP Balance Transfer Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	Best Available Evidence Contact			Hall	Kristi		1-650-336-0300					kristi.hall@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	06/10/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	Chief Financial Officer		Mr.	Epstein	Ethan		1-203-695-1178					ethan.epstein@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	CMS Casework Communication Contact			Goel	Jyotika		1-619-746-2459					jyotika.goel@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	Coordination of Benefits Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	Customer Service Operations Contact			Simon	Jillian		1-209-442-6077					jillian.simon@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	05/19/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	Government Relations Contact			Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	Medicare Compliance Officer		Ms.	Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	Part D Exceptions Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending	1-800-000-0000				PACE - Nat		C	San Francisco
H6317	Pharmacy Network Management Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6317	Pharmacy Technical Help Desk Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending	1-800-000-0000				PACE - Nat		C	San Francisco
H6317	Plan to Plan Reconciliation Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth Bay Area PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6322	Automated TrOOP Balance Transfer Contact	MIG Vice President Pharmacy		Musial	Brian		1-317-822-7523					bmusial@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	03/02/2022	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Best Available Evidence Contact	Director, Claims and Membership		Laney	Vicki		1-810-733-9724					vicki.laney@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Chief Financial Officer	VP & Chief Financial Officer	Ms.	Diehl	Cheryl		1-989-992-3272					cheryl.diehl@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	CMS Casework Communication Contact	Manager, MIG Customer & Provider Operations		Cuccia	Tami		1-810-733-9669					tami.cuccia@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/15/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Coordination of Benefits Contact	Director, Claims and Membership		Laney	Vicki		1-810-733-9724					vicki.laney@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Customer Service Operations Contact	VP, Health Plan Operations		Everett	Torriaun		1-317-822-7439					teverett@mdwise.org	2955 N Meridian St	Ste 201	Indianapolis	IN	46208	01/27/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Government Relations Contact	VP General Counsel		Ehrlich	Matthew		1-810-733-9681					matthew.ehrlich@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Hospice Contact	Pharmacy Project Coordinator		Slater	Angela		1-810-644-1660					angela.slater@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/10/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Anderson	Paula		1-765-631-3511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	07/25/2022	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Part D Exceptions Contact	Pharmacy Project Coordinator		Slater	Angela							angela.slater@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/10/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	1-888-327-0671				HMO - Health Maintenance Organization		C	Chicago
H6322	Pharmacy Network Management Contact	Pharmacy Project Coordinator		Slater	Angela		1-810-244-1660					angela.slater@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/10/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Pharmacy Technical Help Desk Contact	VP Contact Center Services		Battle	Dorry							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/29/2021	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	1-844-336-2678				HMO - Health Maintenance Organization		C	Chicago
H6322	Plan to Plan Reconciliation Contact	Finance Director		de los Reyes	Jamie		1-810-733-9657					jamie.delosreyes@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	04/19/2022	2023	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6328	Automated TrOOP Balance Transfer Contact	Account Manager	Mr.	Battaglia	James		1-330-888-6165				1-330-888-6015	jbattaglia@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Best Available Evidence Contact	Director, Pharmacy	Ms.	May	Amy		1-817-632-2128				1-817-810-5214	Amy.may@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Chief Financial Officer	Controller	Mr.	Aliyev	Elshan		1-817-632-3023					elshan.aliyev@southwesternhealth.org	1601 LBJ FWY	Suite 200	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	CMS Casework Communication Contact	Manager Compliance Operations	Ms.	Atchison	Patricia		1-305-987-4917				1-817-810-5214	Patricia.Atchison@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Coordination of Benefits Contact	Sr Director, Strategic Operations	Mr.	Smith	Charles		1-817-632-3023				1-817-810-5214	charles.smith@southwesternhealth.org	1603 LBJ FWY	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Customer Service Operations Contact	Sr Director, Operations	Mr.	Greene	Shane		1-817-687-4066				1-817-687-4103	Shane.greene@cnchealthplan.com	1603 Lyndon B. Johnson	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Government Relations Contact	Compliance Officer	Ms.	Scott	Elizabeth		1-850-549-5430					elizabeth.scott@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Hospice Contact	Clinical Pharmacy Services	Ms.	May  Pharm D	Amy		1-817-632-2128				1-817-810-5214	amy.may@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Medicare Compliance Officer	Compliance Officer	Ms.	Scott	Elizabeth		1-850-549-5430					elizabeth.scott@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Part D Exceptions Contact	Director, Pharmacy Services	Ms.	May	Amy							amy.may@cnchealthplan.com	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active	1-817-632-2128				PPO - BBA		C	Dallas
H6328	Pharmacy Network Management Contact	Director Pharmacy Network Development	Ms.	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6328	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active	1-855-791-5302				PPO - BBA		C	Dallas
H6328	Plan to Plan Reconciliation Contact	Controller	Mr.	Aliyev	Elshan		1-832-282-3322					elshan.aliyev@southwesternhealth.org	1603 Lyndon B. Johnson Freeway	Suite 300	Farmers Branch	TX	75234	11/30/2022	2023	CARE N' CARE INSURANCE COMPANY, INC.	Local CCP	Care N' Care Insurance Company	Local PPO		Texas Health Resources	709	Yes	Active					PPO - BBA		C	Dallas
H6334	Chief Financial Officer	Chief Financial Officer	Mr.	Heim	John		1-212-586-6400	4551			1-212-586-3596	jheim@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	11/17/2020	2023	NY HOTEL TRADES COUNCIL & HOTEL ASSOCIATION OF NYC	HCPP - 1833 Cost	NY Hotel Trades Council and Hotel Assn. of NYC	HCPP - 1833 Cost		NY Hotel Trades Council&Hotel Assn of NYC	167	No	Active					HCPP		1	New York
H6334	Customer Service Operations Contact	Provider Relations Representative	Mr.	Enoe	Mark		1-212-586-6400	4288				menoe@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2023	NY HOTEL TRADES COUNCIL & HOTEL ASSOCIATION OF NYC	HCPP - 1833 Cost	NY Hotel Trades Council and Hotel Assn. of NYC	HCPP - 1833 Cost		NY Hotel Trades Council&Hotel Assn of NYC	167	No	Active					HCPP		1	New York
H6334	Government Relations Contact	Provider Relations Representative	Mr.	Enoe	Mark		1-212-586-6400	4288			1-212-237-3080	menoe@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	08/29/2019	2023	NY HOTEL TRADES COUNCIL & HOTEL ASSOCIATION OF NYC	HCPP - 1833 Cost	NY Hotel Trades Council and Hotel Assn. of NYC	HCPP - 1833 Cost		NY Hotel Trades Council&Hotel Assn of NYC	167	No	Active					HCPP		1	New York
H6334	Medicare Compliance Officer	Chief External Affairs Officer	Mr.	Yang	Jordan	E	1-212-586-6400	4340			1-212-237-3080	jyang@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	08/30/2019	2023	NY HOTEL TRADES COUNCIL & HOTEL ASSOCIATION OF NYC	HCPP - 1833 Cost	NY Hotel Trades Council and Hotel Assn. of NYC	HCPP - 1833 Cost		NY Hotel Trades Council&Hotel Assn of NYC	167	No	Active					HCPP		1	New York
H6340	Automated TrOOP Balance Transfer Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	Best Available Evidence Contact			Hall	Kristi		1-650-336-0300					kristi.hall@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	Chief Financial Officer		Mr.	Epstein	Ethan		1-203-695-1178					ethan.epstein@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	CMS Casework Communication Contact			Goel	Jyotika		1-619-746-2459					jyotika.goel@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	Coordination of Benefits Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	Customer Service Operations Contact		Mr.	Tung	Yin		1-646-221-8525					yin.tung@welbehealth.com	570 Washington Ave		Plainview	NY	11803	09/28/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	Government Relations Contact			Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	Medicare Compliance Officer		Ms.	Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	Part D Exceptions Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending	1-800-734-8041				PACE - Nat		C	New York
H6340	Pharmacy Network Management Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6340	Pharmacy Technical Help Desk Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending	1-800-734-8041				PACE - Nat		C	New York
H6340	Plan to Plan Reconciliation Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	08/17/2022	2023	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE				Yes	Pending					PACE - Nat		C	New York
H6342	Automated TrOOP Balance Transfer Contact	Financial Services Manager	Mr	Gardner	Scott		1-501-441-8000					Scott.gardner@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	Best Available Evidence Contact			Williams	Sheila		1-501-441-8000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/09/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	Chief Financial Officer	CFO	Mr.	Beaulieu	Brent		1-501-202-2017					brent.beaulieu@baptist-health.org	9601 Baptist Health Drive		Little Rock	AR	72205	11/10/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	CMS Casework Communication Contact	Executive Director	Mrs	Williams	Sheila		1-501-441-8000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	Coordination of Benefits Contact	Financial Services Manager		Gardner	Scott		1-501-441-8000					scott.gardner@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	Customer Service Operations Contact	QI Coordinator		Stoneman	Kimberly		1-501-441-8000					kimberly.stoneman@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	Government Relations Contact	VP Baptist Health		Matlock	Kourtney		1-501-202-1917					kourtney.matlock@baptist-health.org	10825 Financial Centre Parkway	Suite 410	Little Rock	AR	72211	08/12/2021	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	Medicare Compliance Officer	Executive Director	Mrs	Williams	Sheila		1-501-441-8000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/17/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	Part D Exceptions Contact	Executive Director		Williams	Sheila							sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active	1-501-441-8000				PACE - Nat		C	Denver
H6342	Pharmacy Network Management Contact	Medical Director	Dr.	Brathwaite	Jasmine		1-501-441-8000					jabrathwaite@practice-plus.com	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6342	Pharmacy Technical Help Desk Contact	Executive Director		Williams	Sheila							sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active	1-501-441-8000				PACE - Nat		C	Denver
H6342	Plan to Plan Reconciliation Contact			Williams	Sheila		1-501-441-8000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2023	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	Denver
H6345	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/01/2019	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Chief Financial Officer	CFO	Mr	Small	Phil		1-770-279-6200					PhSmall@pruitthealth.com	1626 Jeurgens Ct		Norcross	GA	30093	12/15/2021	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/01/2019	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Christopher	Laura	K	1-404-694-4897					compliance@pruitthealthpremier.com	1626 Jeurgens Court		Norcross	GA	30093	06/07/2022	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/15/2021	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Atlanta
H6345	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/15/2021	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6345	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Atlanta
H6345	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Premier, LLC	622	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6348	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H6348	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6348	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H6348	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	COORDINATED CARE CORPORATION	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6351	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Best Available Evidence Contact			Oliver	David		1-910-263-2306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/05/2020	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Chief Financial Officer	CFO	Mr.	Calcutt	Joseph	V	1-910-332-1793					jcalcutt@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	03/08/2021	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	CMS Casework Communication Contact			Oliver	David		1-910-263-2306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Coordination of Benefits Contact			Fawson	Leesa		1-910-660-4772					lfawson@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/27/2022	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Customer Service Operations Contact	Compliance Officer		Oliver	David		1-910-263-2306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	07/26/2022	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Government Relations Contact			Oliver	David		1-910-263-2306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Hospice Contact			Oliver	David		1-910-263-2306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Medicare Compliance Officer	Compliance Officer	Ms.	Oliver	David		1-910-263-2306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	07/26/2022	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Part D Exceptions Contact			Fawson	Leesa							lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active	1-910-660-4772				HMO - Health Maintenance Organization		C	Atlanta
H6351	Pharmacy Network Management Contact	Associate Director, Provider Services, Operations		Burdick	Tammy		1-920-221-4089				1-920-221-4589	Tammy.Burdick@Navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Atlanta
H6351	Plan to Plan Reconciliation Contact			Fawson	Leesa		1-910-660-4772					lfawson@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	12/09/2020	2023	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6371	Automated TrOOP Balance Transfer Contact	Executive Director	Ms.	Iavarone	Maria		1-201-499-3900	3879			1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	Best Available Evidence Contact	Executive Director	Ms.	Iavarone	Maria		1-201-499-3900	3879			1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	Chief Financial Officer	CFO	Ms	Richman	Jeannine	M	1-609-781-1379				1-609-747-4140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	CMS Casework Communication Contact	Executive Director	Ms.	Iavarone	Maria		1-201-499-3900	3879			1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	Coordination of Benefits Contact	Executive Director	Ms.	Iavarone	Maria		1-201-499-3900	3879			1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	Customer Service Operations Contact	Executive Director	Ms.	Iavarone	Maria		1-201-499-3900	3879			1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	Government Relations Contact	Executive Director	Ms.	Iavarone	Maria		1-201-499-3900	3879			1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	Medicare Compliance Officer	Compliance Officer	Mrs.	Alvarado-Marin	Deanna		1-201-499-3900	3897			1-201-706-2092	dalvarado@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	01/11/2022	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	Part D Exceptions Contact	Executive Director	Ms.	Iavarone	Maria						1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active	1-201-499-3900	3879			PACE - Nat		C	New York
H6371	Pharmacy Network Management Contact	Executive Director	Ms.	Iavarone	Maria		1-201-499-3900	3879			1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6371	Pharmacy Technical Help Desk Contact	Executive Director	Ms.	Iavarone	Maria						1-201-706-2092	miavarone@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/03/2021	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active	1-201-499-3900	3879			PACE - Nat		C	New York
H6371	Plan to Plan Reconciliation Contact	CFO	Ms	Richman	Jeannine	M	1-609-781-1379				1-609-747-4140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2023	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active					PACE - Nat		C	New York
H6378	Automated TrOOP Balance Transfer Contact	Manager, Technical Delivery & Oversight	Mr.	Gajarajan	Nivi		1-267-825-8648					ngajarajan2@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		1-484-497-1171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Chief Financial Officer	Chief Financial Officer	Mr.	Burgoyne	Michael		1-215-937-8875					mburgoyne@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	100 Stevens Drive	Philadelphia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	CMS Casework Communication Contact	Medicare QA Contract Acct Mgr	Ms.	Fine	Nicole		1-484-496-7479					nfine@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	10/17/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Coordination of Benefits Contact	Manager, Provider Network Oversight	Ms.	Williams	Kathy		1-843-746-7499					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		1-267-298-1794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	08/04/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Government Relations Contact	VP, Government Relations		Cozzo	Mr.Steven		1-215-937-8236					scozzo@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Hospice Contact	Director of Pharmacy, Medicare	Ms.	Shepard	Jen		1-215-937-8685					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Solomon	Mary		1-267-300-4846					mlsolomon@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	100 Stevens Drive, 2flr.	Philadelphia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						1-215-863-5100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-215-863-6483				HMO - Health Maintenance Organization		C	Philadelphia
H6378	Pharmacy Network Management Contact	Manager, Pharmacy Network Operations	Mr.	King	James		1-843-569-4845					jking@performrx.com	PerformRx	200 Stevens Dr.	Philadelphia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6378	Pharmacy Technical Help Desk Contact	Director, Service Operations	Ms.	Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/07/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-855-327-0511				HMO - Health Maintenance Organization		C	Philadelphia
H6378	Plan to Plan Reconciliation Contact	Director, Medicare Performance Management	Mr.	Kindred	Amanda		1-248-404-5991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6379	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-614-336-3326				HMO - Health Maintenance Organization		C	Chicago
H6379	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Pharmacy Technical Help Desk Contact			Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	08/04/2021	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H6379	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6396	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		1-937-818-7479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Best Available Evidence Contact	Enrollment Team Lead	Mr.	Richardson	Kal		1-937-224-3300	3437			1-937-425-0909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	02/02/2016	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Chief Financial Officer	Chief Financial Officer	Mr.	Smart	Lawrence		1-937-531-3335					Lawrence.Smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/05/2021	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	CMS Casework Communication Contact	Director, Grievance and Appeals	Ms.	Acuna	Celeste		1-480-640-6815					celeste.acuna@caresource.com	P.O. Box 1947		Dayton	OH	45401	01/20/2022	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Coordination of Benefits Contact	Manager, Enrollment Operations	Mr.	Spivey	Michael		1-937-531-3682				1-937-487-0643	COBInquiry@caresource.com	230 N. Main St.		Dayton	OH	45402	04/15/2022	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Customer Service Operations Contact	Director, Customer Care		Cary	Lisa		1-937-232-6458					lisa.cary@caresource.com	40 W 2nd St		Dayton	OH	45402	10/04/2021	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Government Relations Contact	Director, Medicare Compliance Officer	Ms.	de Cardenas	Deonys		1-678-471-0101					deonys.decardenas@caresource.com	230 North Main Street		Dayton	OH	45402	05/04/2021	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Hospice Contact	Director, Enrollment	Mr.	Castro	Armando		1-937-531-2291					armando.castro@caresource.com	230 N Main St		Dayton	OH	45402	05/29/2020	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	de Cardenas	Deonys		1-678-471-0101					deonys.decardenas@caresource.com	230 N. Main St.		Dayton	OH	45402	05/04/2021	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/08/2022	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	New York
H6396	Pharmacy Network Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		1-937-818-7479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6396	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/22/2021	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H6396	Plan to Plan Reconciliation Contact	Manager, Accounting	Ms.	North	Sara		1-937-531-2669					CareSourceP2P@caresource.com	CareSource Accounting	PO Box 2208	Dayton	OH	45401	08/26/2020	2023	CARESOURCE OHIO, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6399	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/16/2022	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	05/04/2020	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	CMS Casework Communication Contact	Lead Director		Leskovac	Tara		1-614-563-7807					leskovact@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/20/2022	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Coordination of Benefits Contact	Director of Pharmacy		Stekol	Ilona		1-347-880-6082					StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	04/29/2022	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		1-866-600-2139					PhillipsL1@aetna.com	7400 Camous Road		New Albany	OH	43054	01/24/2020	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Government Relations Contact	Vice President, Duals Markets	Mr	Smith	Jason		1-614-551-4237					SmithT25@aetna.com	4500 E. Cotton Center Blvd.		Phoenix	AZ	85040	01/13/2022	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Hospice Contact	Director, Service Operations		Truitt	Michelle		1-717-671-6847					MLTruitt@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	07/01/2020	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/24/2020	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Part D Exceptions Contact	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/05/2022	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-347-880-6082				HMO - Health Maintenance Organization		C	Philadelphia
H6399	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6399	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	04/29/2022	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H6399	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6408	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		1-614-546-3183				1-614-546-3131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		1-614-546-3222				1-614-546-3148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		1-614-546-3211				1-614-546-3131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	CMS Casework Communication Contact	Compliance Specialist	Mr.	Jordan	David	A	1-614-706-8474				1-614-234-8372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Customer Service Operations Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		1-614-546-3180				1-614-546-3132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Government Relations Contact	CEO	Mr	Randolph	John	C	1-614-546-3152				1-614-546-3131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		1-412-478-0244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Part D Exceptions Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	1-800-240-3851				HMO - Health Maintenance Organization		C	Chicago
H6408	Pharmacy Network Management Contact	Director, Pharmacy	Mr	Turoff	Chris		1-614-403-0394					chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6408	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H6408	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6425	Automated TrOOP Balance Transfer Contact	Business Office	Ms.	Huskey	Lauren		1-479-463-6609				1-479-463-6601	lhuskey@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	01/03/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	Best Available Evidence Contact	Marketing and Intake	Ms	Carter	Tessa		1-479-463-6619				1-479-463-6601	tcarter@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/29/2020	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	Chief Financial Officer	Controller	Mr	Burrows	DJ		1-479-463-1120					dburrows@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	01/07/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	CMS Casework Communication Contact	Executive Director	Mr	Morris	Jack		1-479-463-6611				1-479-463-6601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	Coordination of Benefits Contact	Business Office	Ms	Huskey	Lauren		1-479-463-6609				1-479-463-6601	lhuskey@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	07/12/2021	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	Customer Service Operations Contact	Business Office Coordinator	Ms	Huskey	Lauren		1-479-463-6609				1-479-463-6601	lhuskey@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	04/18/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	Government Relations Contact	Executive Director	Mr	Morris	Jack		1-479-463-6611				1-479-463-6601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	Medicare Compliance Officer	Executive Director	Mr	Morris	Jack		1-479-463-6611				1-479-463-6601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	Part D Exceptions Contact	Executive Director	Mr	Morris	Jack						1-479-463-6601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active	1-479-463-6611				PACE - Nat		C	Denver
H6425	Pharmacy Network Management Contact	Executive Director	Mr	Morris	Jack		1-479-463-6611				1-479-463-6601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6425	Pharmacy Technical Help Desk Contact	Executive Director	Mr	Morris	Jack						1-479-463-6601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active	1-479-463-6600				PACE - Nat		C	Denver
H6425	Plan to Plan Reconciliation Contact	Business Office Coordinator	Ms.	Huskey	Lauren		1-479-463-6609				1-479-463-6601	lhuskey@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	02/16/2022	2023	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical Center	686	Yes	Active					PACE - Nat		C	Denver
H6446	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H6446	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6446	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H6446	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Automated TrOOP Balance Transfer Contact	Controller	Ms.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 Desiard Street	#300	Monroe	LA	71201	12/30/2020	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Best Available Evidence Contact	Medicare Enrollment Supervisor	Ms.	Brasher	Michele		1-318-998-3083					mbrasher@vhpla.com	130 Desiard Street	#300	Monroe	LA	71201	12/30/2020	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Chief Financial Officer	Chief Financial Officer	Mr.	Short	Adam		1-225-295-2189					adam.short@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	03/07/2022	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	CMS Casework Communication Contact	SVP and COO, Government Business	Mr.	Faulk	Sheldon		1-225-295-2079					sheldon.faulk@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/07/2018	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Coordination of Benefits Contact	Medicare Enrollment Supervisor	Ms.	Brasher	Michele		1-318-998-3083					mbrasher@vhpla.com	130 Desiard Street		Monroe	LA	71201	12/30/2020	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Customer Service Operations Contact	Director of Member Services	Ms.	Trichel	Amy		1-318-998-2870					atrichel@vhpla.com	130 Desiard Street		Monroe	LA	71201	12/30/2020	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Government Relations Contact	Director, Medicare Advantage Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					macompliance@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	05/06/2020	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Hospice Contact	Account Manager - Express Scripts	Ms.	Morgan	Stacy		1-480-281-8763					slmorgan@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	12/30/2020	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Medicare Compliance Officer	Director, Medicare Advantage Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					wesley.miller@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	05/06/2020	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian							Brian_Schumm@Express-Scripts.com	5151 Blazer Memorial Parkway		Dublin	OH	43017	02/03/2016	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	Dallas
H6453	Pharmacy Network Management Contact	Network Account Dir, Retail Strategy & Contracting	Ms.	Kelly	Heather		1-314-692-1866					Hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	10/24/2016	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6453	Pharmacy Technical Help Desk Contact	Sr. Manager - Memeber Services Contact Center		McVey	Darcheena							Darcheena_McVey@express-scripts.com	1640 Century Center Pkwy		Memphis	TN	38134	08/07/2018	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Dallas
H6453	Plan to Plan Reconciliation Contact	Senior Accountant, Financial Reporting	Ms.	Brown	Leigh Ann		1-225-953-3055					Leigh-Ann.Brown@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	02/23/2021	2023	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6502	Automated TrOOP Balance Transfer Contact	Manager, Business Process		Diaz	Mario		1-949-475-3517					mario.diaz@optum.com	1100 Optum Circle		Eden Prairie	MN	55344	01/04/2021	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Best Available Evidence Contact	Director of Operations		Power	Donna		1-816-395-3259					Donna.Power@bluekc.com	2301 Main St		Kansas City	MO	64108	10/01/2020	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Chief Financial Officer		Mr.	Cournand	Henri		1-816-395-2323					Henri.Cournand@BlueKC.com	2301 Main Street		Kansas City	MO	64108	09/03/2019	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	CMS Casework Communication Contact			Muncy	Angela		1-816-395-3648					Angela.Muncy@BlueKC.com	2301 Main Street		Kansas City	MO	64108	07/23/2018	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Coordination of Benefits Contact			Phillips	Denise		1-816-395-2032					_MSP_COB@BlueKC.com	2301 Main Street		Kansas City	MO	64108	05/10/2022	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Customer Service Operations Contact	Director of Operations		Power	Donna		1-816-395-3259					Donna.Power@bluekc.com	2301 Main St		Kansas City	MO	64108	10/01/2020	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Government Relations Contact			Hoey	Yen		1-816-395-3664					yen.hoey@bluekc.com	2301 Main Street		Kansas City	MO	64108	09/03/2019	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Hospice Contact			McMenus	Cindy		1-816-395-2226					cindy.mcmenus@bluekc.com	2301 Main Street		Kansas City	MO	64108	12/31/2020	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Medicare Compliance Officer		Mrs.	Muncy	Angela		1-816-395-3648					Angela.Muncy@BlueKC.com	2301 Main Street		Kansas City	MO	64108	01/04/2019	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Part D Exceptions Contact			Bricker	Bryce							bryce.m.bricker@optum.com	9040 S. Rita Rd		Tucson	AZ	85747	12/31/2020	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active	1-612-632-6838				PPO - BBA		C	Kansas City
H6502	Pharmacy Network Management Contact			Hagan	Kyle		1-303-989-5828					kyle.hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/31/2020	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6502	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Summers	Todd							todd.summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	12/27/2021	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active	1-866-443-1095				PPO - BBA		C	Kansas City
H6502	Plan to Plan Reconciliation Contact	Accountant, Lead		Bresee	Mickey		1-816-395-3145					_P2P_Report@bluekc.com	2301 Main Street	ATTN: P2P Department	Kansas City	MO	64108	08/22/2022	2023	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Blue Medicare Advantage	Local PPO		Blue Cross and Blue Shield of Kansas City	614	Yes	Active					PPO - BBA		C	Kansas City
H6509	Automated TrOOP Balance Transfer Contact	COO/CFO	Mr	Nguyen	Larry		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	Best Available Evidence Contact	CEO	Mr	Tharasri	Luke		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	Chief Financial Officer		Mr	Nguyen	Larry		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	CMS Casework Communication Contact	CSO	Mr	Possick	Arnold		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	Coordination of Benefits Contact	COO/CFO	Mr	Nguyen	Larry		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	Customer Service Operations Contact	CSO	Mr	Possick	Arnold		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	Government Relations Contact	CSO	Mr	Possick	Arnold		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	Medicare Compliance Officer		Mr	Possick	Arnold		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	Part D Exceptions Contact	COO/CFO	Mr	Nguyen	Larry							info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending	1-800-808-6609				PACE - Nat		C	San Francisco
H6509	Pharmacy Network Management Contact	CEO	Mr	Tharasri	Luke		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6509	Pharmacy Technical Help Desk Contact			Possick	Arnold							info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending	1-800-808-6609				PACE - Nat		C	San Francisco
H6509	Plan to Plan Reconciliation Contact			Possick	Arnold		1-800-808-6609					info@360pace.com	13800 Arizona Street		Westminster	CA	92683	12/14/2022	2023	360 PACE OF RIVERSIDE, INC.	National PACE	360 PACE of Riverside, Inc.	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Automated TrOOP Balance Transfer Contact	CFO	Mr	Diaz	Javier		1-559-737-4786					javdiaz@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Best Available Evidence Contact	Deputy CEO	Mr	Vawter	Chad		1-559-737-4907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Chief Financial Officer	CFO	Mr	Diaz	Javier		1-559-737-4786					javdiaz@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	CMS Casework Communication Contact	Deputy CEO	Mr	Vawter	Chad		1-559-737-4907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Coordination of Benefits Contact	CFO	Mr	Diaz	Javier		1-559-737-4786					javdiaz@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Customer Service Operations Contact	Deputy CEO	Mr	Vawter	Chad		1-559-737-4907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Government Relations Contact	Deputy CEO	Mr	Vawter	Chad		1-559-737-4907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Medicare Compliance Officer	Deputy CEO	Mr	Vawter	Chad		1-559-737-4907				1-559-737-4907	cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Part D Exceptions Contact	Deputy CEO	Mr	Vawter	Chad							cvwater@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending	1-559-737-4907				PACE - Nat		C	San Francisco
H6517	Pharmacy Network Management Contact	Deputy CEO	Mr	Vawter	Chad		1-559-737-4907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6517	Pharmacy Technical Help Desk Contact	Deputy CEO	Mr	Vawter	Chad							cvwater@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending	1-559-737-4907				PACE - Nat		C	San Francisco
H6517	Plan to Plan Reconciliation Contact	Deputy CEO	Mr	Vawter	Chad		1-559-737-4907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2023	FAMILY HEALTHCARE NETWORK	National PACE	Family HealthCare Network PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6526	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/27/2018	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H6526	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6526	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H6526	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF NEW MEXICO, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6528	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H6528	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6528	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	04/28/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H6528	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H6529	Automated TrOOP Balance Transfer Contact	Director of Data Integration & Development	Mr.	Katheeder	Tim		1-812-378-7066					Tim.Katheeder@siho.org	PO Box 1787		Columbus	IN	47202-1787	01/05/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Best Available Evidence Contact	Claims Director		Coomer	Dawn		1-812-314-2500	1106				Dawn.Coomer@siho.org	PO Box 1787		Columbus	IN	47202-1787	07/15/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Chief Financial Officer	Chief Financial Officer	Ms.	Newell	Wendy		1-812-378-7040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	08/20/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	CMS Casework Communication Contact	Manager of Quality Assurance		Do	Nicole		1-812-314-2500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/03/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Coordination of Benefits Contact	Manager of Quality Assurance		Do	Nicole		1-812-314-2500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/03/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Customer Service Operations Contact	Director of Customer Service		Diedrich	Bridget		1-812-314-2500	1073				Bridget.Diedrich@siho.org	PO Box 1787		Columbus	IN	47202-1787	10/05/2020	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Government Relations Contact	COO	Mr.	McConnell	Roy		1-832-385-8189					Roy.McConnell@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	05/10/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Hospice Contact	Vice President, Integrated Care Delivery		Kiel	Jordan		1-812-314-2500	1072				jordan.kiel@siho.org	PO Box 1787		Columbus	IN	47201	05/24/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Marx	David		1-812-378-7101					David.Marx@siho.org	417 Washington Street		Columbus	IN	47201	12/13/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Part D Exceptions Contact	Compliance Risk Coordinator		Helsley	Kim							Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/20/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active	1-812-314-2500	1103			HMO - Health Maintenance Organization		C	Chicago
H6529	Pharmacy Network Management Contact	Compliance Risk Coordinator		Helsley	Kim		1-812-314-2500	1103				Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	10/22/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6529	Pharmacy Technical Help Desk Contact	Compliance Risk Coordinator		Helsley	Kim							Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/20/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H6529	Plan to Plan Reconciliation Contact	Staff Accountant I		Dobbs	Rachel		1-812-314-2500	1202				rachel.dobbs@siho.org	417 Washington Street		Columbus	IN	47201	05/12/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6541	Automated TrOOP Balance Transfer Contact	CFO	Mr.	Jones	Kevin		1-859-623-4080					kjones@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	06/08/2022	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Best Available Evidence Contact			Upchurch	Kelly		1-859-623-4080					kellyupchurch@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	02/09/2021	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Chief Financial Officer	CFO	Mr.	Jones	Kevin		1-859-623-4080					kjones@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	CMS Casework Communication Contact	Executive Director		Hickman	Stacey		1-606-309-9068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Coordination of Benefits Contact	Executive Director		Hickman	Stacey		1-606-309-9068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/07/2022	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Customer Service Operations Contact	Executive Director		Hickman	Stacey		1-606-309-9068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Government Relations Contact	CEO	Mr.	Upchurch	Kelly		1-859-623-4080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Medicare Compliance Officer	Compliance officer	Ms.	Reece	Jennifer		1-859-314-7284					jreece@forhorizon.com	178 Broadway Street		Irvine	KY	40336	06/07/2022	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part D Exceptions Contact	CEO	Mr.	Upchurch	Kelly						1-859-624-5771	kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active	1-859-623-4080				PACE - Nat		C	Atlanta
H6541	Pharmacy Network Management Contact	COO	Ms.	Burchett	Melinda		1-606-305-3028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Pharmacy Technical Help Desk Contact	CEO	Mr.	Upchurch	Kelly						1-859-624-5771	kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active	1-859-623-4080				PACE - Nat		C	Atlanta
H6541	Plan to Plan Reconciliation Contact	CFO	Mr.	Jones	Kevin		1-859-623-4080					kjones@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	06/08/2022	2023	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6545	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H6545	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6545	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H6545	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ILLINOIS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6550	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H6550	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6550	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H6550	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6551	Automated TrOOP Balance Transfer Contact	Accounting Specialist	Ms	Kassimu	Gabrielle		1-267-991-7634					Gabrielle.Kassimu@trinity-health.org	St. Mary Medical Center	1201 Langhorne-Newtown Rd.	Langhorne	PA	19057	09/09/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Best Available Evidence Contact	Executive Director	Mrs.	Sheehan	Mary Ann		1-267-991-7620				1-267-991-7618	masheehan@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/09/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Chief Financial Officer	Regional Finance Director	Mr.	Schmotzer	David	P	1-215-339-4533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	CMS Casework Communication Contact	Director Quality & Compliance	Ms	Trotter	Lorraine		1-267-991-7626				1-267-991-7618	ltrotter@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/03/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Coordination of Benefits Contact	Regional Finance Director	Mr.	Schmotzer	David	P	1-215-339-4533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Customer Service Operations Contact	Director Quality & Compliance	Ms	Trotter	Lorraine		1-267-991-7626				1-267-991-7618	ltrotter@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/03/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Government Relations Contact	Executive Director	Mrs.	Sheehan	Mary Ann		1-267-991-7620				1-267-991-7618	masheehan@stmaryhealthcare.org	2500 Northgate Road		Trevose	PA	19053	04/23/2018	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/01/2020	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Part D Exceptions Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	09/03/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Philadelphia
H6551	Pharmacy Network Management Contact	Manager Part D Compliance		Garbarino	Joseph		1-215-339-4362					joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/09/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Pharmacy Technical Help Desk Contact	Manager Part D Compliance		Garbarino	Joseph							joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/09/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Philadelphia
H6551	Plan to Plan Reconciliation Contact	Director of Finance	Mr.	Schmotzer	David	P	1-215-339-4533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2023	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6586	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H6586	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6586	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H6586	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6594	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H6594	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6594	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H6594	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6595	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H6595	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6595	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H6595	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6596	Automated TrOOP Balance Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		1-800-333-2535	79089				Christina.Farrar@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/24/2019	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	Best Available Evidence Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		1-800-333-2535	79089				Christina.Farrar@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/24/2019	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	Chief Financial Officer	Chief Financial Officer	Mr.	Bailey	Todd		1-508-368-9097				1-508-791-4332	Todd.Bailey@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	08/27/2019	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	CMS Casework Communication Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		1-508-799-2100	79275				Ulfves.Heather@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	08/07/2018	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	Coordination of Benefits Contact	Senior Director, Claims Administration	Ms	Straitiff	Kirsten		1-508-368-9047					kirsten.straitiff@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	09/20/2022	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	Customer Service Operations Contact	VP, Customer Service	Mr.	Perron	Donald		1-508-368-9701					Donald.Perron@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/26/2016	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	Government Relations Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		1-508-368-9539					Lisa.Lashbrook@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/26/2016	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	Medicare Compliance Officer	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		1-508-368-9539					Lisa.Lashbrook@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/26/2016	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	Part D Exceptions Contact	Manager, Pharmacy Ops & Clinical Programs	Mr.	Sartini	David							David.Sartini@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/26/2017	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	1-508-368-9790				PACE - Nat		C	New York
H6596	Pharmacy Network Management Contact	VP, Pharmacy Services	Mr.	Barner	Benjamin		1-508-368-9660					Benjamin.Barner@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608-2810	09/19/2022	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6596	Pharmacy Technical Help Desk Contact			Help Desk	OptumRx								1600 McConnor Parkway		Schaumburg	IL	60173	12/29/2021	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	1-844-368-8734				PACE - Nat		C	New York
H6596	Plan to Plan Reconciliation Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		1-508-368-9085					Shawn.McNamara@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/26/2016	2023	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6605	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H6605	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6605	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H6605	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF HAWAII, INC.	Local CCP	Wellcare by ‘Ohana Health Plan	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6622	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H6622	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H6622	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6652	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-855-521-0626				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H6652	Pharmacy Network Management Contact	Director of Pharmacy Network Contracting		Dyer	Tim		1-330-888-4812				1-330-405-8094	tdyer@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6652	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	09/07/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-833-674-6202				HMO - Health Maintenance Organization		C	Dallas
H6652	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/12/2021	2023	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6672	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-614-336-3326				HMO - Health Maintenance Organization		C	Chicago
H6672	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Pharmacy Technical Help Desk Contact			Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	08/04/2021	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H6672	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6678	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/02/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H6678	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6678	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H6678	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6706	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H6706	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6706	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H6706	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/21/2020	2023	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6713	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/16/2022	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H6713	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6713	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H6713	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE OF ILLINOIS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6723	Automated TrOOP Balance Transfer Contact			Goff	Katherine		1-216-687-7344					Katherine.Goff@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	06/02/2015	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Best Available Evidence Contact	Medicare Operations Analyst II		Crowley	Lauren		1-216-687-6585					BAEdocs@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	10/12/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Chief Financial Officer		Mr.	Mueller	Raymond		1-216-687-7828					raymond.mueller@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	02/02/2015	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	CMS Casework Communication Contact			Lee	Anissa		1-216-687-7059					Anissa.Lee@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/10/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Coordination of Benefits Contact	Director, Financial Payment and Review		Palace	Ted		1-216-687-2807					Ted.Palace@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	01/31/2019	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Customer Service Operations Contact	Dir, Customer Care		Lee	Anissa		1-216-687-7059	77059				Anissa.Lee@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	02/11/2020	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Government Relations Contact			Slee	Nicole		1-614-306-6271					Nicole.Slee@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/31/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Hospice Contact			Goff	Katherine		1-216-687-7344					Katherine.Goff@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	02/15/2018	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Slee	Nicole		1-614-306-6271					nicole.slee@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/31/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/14/2016	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	1-614-336-3326				HMO - Health Maintenance Organization		C	Chicago
H6723	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	02/02/2015	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6723	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	4700 North Hanley		St. Louis	MO	63134	12/23/2021	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H6723	Plan to Plan Reconciliation Contact			Stepic	Michelle		1-216-687-7151					Michelle.Stepic@medmutual.com	2060 East Ninth Street		Cleveland	OH	44115	12/04/2017	2023	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6743	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		1-858-790-6445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Best Available Evidence Contact	Enrollment Manager		Vredenburg	Cristi		1-541-492-5119					Cristi.vredenburg@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	08/04/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Chief Financial Officer	Chief Financial Officer	Mr.	Desai	Roshan		1-727-251-8934				1-503-584-1772	Roshan.Desai@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	05/18/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	CMS Casework Communication Contact	Enrollment Manager		Vredenburg	Cristi		1-541-492-5119					Cristi.vredenburg@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	08/04/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Coordination of Benefits Contact	Chief Operations Officer	Ms.	Regalado	Mae		1-951-206-7316					mae.regalado@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	03/04/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Customer Service Operations Contact	Chief Operations Officer	Ms.	Regalado	Mae		1-951-206-7316					mae.regalado@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	03/04/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Government Relations Contact	Chief Compliance Officer		Flynn	Jordan		1-602-692-4381				1-503-584-1772	Jordan.flynn@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	07/08/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Hospice Contact	VP of Pharmacy Operations	Ms.	Liu	Helen		1-970-712-9377					helen.liu@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	12/08/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Flynn	Jordan		1-602-692-4381				1-503-584-1772	Jordan.flynn@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	07/08/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Part D Exceptions Contact	Director of Appeals and Grievances		Vaughn	Sara						1-541-672-8670	sara.vaughn@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	11/11/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	1-877-672-8620	3			PPO - BBA		C	Seattle
H6743	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/13/2019	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6743	Pharmacy Technical Help Desk Contact	Director, Contact Center Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/08/2018	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	1-800-681-9571				PPO - BBA		C	Seattle
H6743	Plan to Plan Reconciliation Contact	Chief Financial Officer		Desai	Roshan		1-727-251-8934				1-503-584-1772	Roshan.Desai@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	05/18/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H6750	Automated TrOOP Balance Transfer Contact	Medicare Pharmacy Program Manager		Hursey	Erica		1-781-612-1000	82845			1-617-509-9144	erica.hursey@point32health.org	One Wellness Way		Canton	MA	02021	01/20/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Best Available Evidence Contact	Director, Medicare Advantage Operations		Longo	Karen		1-781-612-1000	83439				karen.longo@point32health.org	One Wellness Way		Canton	MA	02021	01/20/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Chief Financial Officer	SVP Chief Financial Officer	Mr.	Kurpad	Umesh		1-781-612-1000	84968				umesh.kurpad@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	CMS Casework Communication Contact	Manager, Appeals & Grievances		Snyder	Katherine		1-781-612-3467					Katherine.Snyder@point32health.org	1 Wellness Way		Canton	MA	02021	01/21/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Coordination of Benefits Contact	Director, Medicare Advantage Operations		Longo	Karen		1-781-612-3439				1-617-509-7531	karen.longo@point32health.org	1 Wellness Way		Canton	MA	02021	01/20/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Customer Service Operations Contact	Medicare Operations Manager		Washburn	Glenn		1-617-509-1624					glenn.washburn@point32health.org	1600 Crown Colony Dr		Quincy	MA	02169	01/21/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Government Relations Contact	Chief Government Affairs Officer	Ms.	Lewis	Kristin		1-781-612-1000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Hospice Contact	Manager, Medicare Advantage Operations		Peck	Joann		1-781-612-3273					joann.peck@point32health.org	1 Wellness Way		Canton	MA	02021	01/20/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Taylor	James		1-781-612-1000	88089				james.taylor@point32health.org	1 Wellness Way		Canton	MA	02021	01/04/2023	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Part D Exceptions Contact	Medicare Pharmacy Program Manager		Hursey	Erica						1-781-612-2845	erica.hursey@point32health.org	1 Wellness Way		Canton	MA	02021	01/20/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-617-509-9596				HMO - Health Maintenance Organization		C	Boston
H6750	Pharmacy Network Management Contact	Manager Retail Network Operations		Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Avenue		Lakewood	CO	80232	09/28/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6750	Pharmacy Technical Help Desk Contact			Summers	Todd							Todd.Summers@optum.com	755 Research Pkwy Suite 300		Oklahoma City	OK	73104	11/05/2020	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-855-524-0380				HMO - Health Maintenance Organization		C	Boston
H6750	Plan to Plan Reconciliation Contact	Senior Accountant - Provider Accounting		Dwin	Mark		1-781-612-3910				1-617-509-1778	mark.dwin@point32health.org	1 Wellness Way		Canton	MA	02021	01/21/2022	2023	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Local CCP	Harvard Pilgrim Health Care of New England, Inc.	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6759	Automated TrOOP Balance Transfer Contact	Business Office Manager		Cox	Terra		1-970-508-7737				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	Best Available Evidence Contact	Executive Director	Ms	Booker	Chiquita		1-952-941-0305				1-952-941-0428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	Chief Financial Officer	VP of Financial Services	Ms	Gavin	Nancy		1-612-428-7840				1-952-941-0428	ngavin@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	CMS Casework Communication Contact	Executive Director	Ms	Booker	Chiquita		1-952-941-0305				1-952-941-0428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	Coordination of Benefits Contact	Business Office Manager		Cox	Terra		1-970-964-3556				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	Customer Service Operations Contact	Executive Director	Ms	Booker	Chiquita		1-952-941-0305				1-952-941-0428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	Government Relations Contact	Executive Director	Ms	Booker	Chiquita		1-952-941-0305				1-952-941-0428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	Medicare Compliance Officer	Director of Program Integrity/Compliance	Ms	Linnell	Kathryn	R	1-970-508-7757				1-866-829-9949	klinnell@voa.org	2377 Robins Way		Montrose	CO	81401	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	Part D Exceptions Contact	Business Manager		Cox	Terra						1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending	1-970-508-7737				PACE - Nat		C	Atlanta
H6759	Pharmacy Network Management Contact	Executive Director		Howell	Keith		1-970-964-3500				1-970-252-0166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6759	Pharmacy Technical Help Desk Contact	Executive Director		Howell	Keith						1-970-252-0166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending	1-970-964-3500				PACE - Nat		C	Atlanta
H6759	Plan to Plan Reconciliation Contact	Business Office Manager		Cox	Terra		1-970-508-7737				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	06/15/2022	2023	SENIOR COMMUNITY CARE OF KENTUCKY	National PACE	Senior CommUnity Care of Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6765	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Denver
H6765	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@ElixirSolutions.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/17/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6765	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-833-502-6757				HMO - Health Maintenance Organization		C	Denver
H6765	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6776	Automated TrOOP Balance Transfer Contact	VP of ITS		Ramaglia	Damon		1-347-842-3584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	04/25/2018	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Best Available Evidence Contact	VP of Operational Support		Rosen	Richard		1-347-842-3684					richard.rosen@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Chief Financial Officer	Senior Vice President of Finance	Mr.	Cavaliere	Andrew		1-347-842-3505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/07/2019	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	CMS Casework Communication Contact	Executive Vice President		Aldrich	Susan	Y	1-914-960-4407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Coordination of Benefits Contact	Senior Vice President of Finance		Kehoe	John		1-347-842-3505					John.Kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	11/01/2022	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Customer Service Operations Contact	Vice President of Member Services		Hron	Patty		1-347-842-3541					patty.hron@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/07/2019	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Government Relations Contact	Executive Vice President		Aldrich	Susan	Y	1-914-960-4407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Hospice Contact	Senior Vice President	Ms.	Lau	Julieanne		1-347-842-3554					julieanne.lau@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	03/25/2022	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Medicare Compliance Officer	Senior Vice President of Regulatory Affairs	Esq.	Ling	Jenny		1-347-842-3528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	ESI	5151 Blazer Pkwy	Dublin	OH	43017	11/07/2022	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	New York
H6776	Pharmacy Network Management Contact	Network Account, Director, Retail Strategy Network		Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	ESI	1 Express Way	St. Louis	MO	63121	10/28/2022	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6776	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	ESI	13051 N Telecom Pkwy Ste 150	Temple Terrace	FL	33637	11/07/2022	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H6776	Plan to Plan Reconciliation Contact	AVP of Finance		Lugo	Michelle		1-347-842-3557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/19/2021	2023	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		RiverSpring Living Holding Corp.	524	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6787	Automated TrOOP Balance Transfer Contact	Business Office Manager		Cox	Terra		1-970-508-7737				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	06/15/2022	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	Best Available Evidence Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	Chief Financial Officer	VP of Financial Services	Ms	Gavin	Nancy		1-612-428-7840				1-952-941-0428	ngavin@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	CMS Casework Communication Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	Coordination of Benefits Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	Customer Service Operations Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	Government Relations Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	Medicare Compliance Officer	PACE Director of Program Integrity/Compliance	Ms.	Linnell	Kathryn	R	1-970-508-7757				1-866-829-9949	klinnell@voa.org	2377 Robins Way		Montrose	CO	81401	12/28/2021	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	Part D Exceptions Contact	Executive Director	Mr.	Robbins	Ken						1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active	1-517-319-0690				PACE - Nat		C	Chicago
H6787	Pharmacy Network Management Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6787	Pharmacy Technical Help Desk Contact	Executive Director	Mr.	Robbins	Ken						1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active	1-517-319-0690				PACE - Nat		C	Chicago
H6787	Plan to Plan Reconciliation Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	03/11/2020	2023	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Chicago
H6796	Automated TrOOP Balance Transfer Contact			Sanders	Sara		1-760-344-9951					saras@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	Best Available Evidence Contact			Sanders	Sara		1-760-344-9951					saras@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	Chief Financial Officer		Ms.	Rizzo	Marlene		1-760-344-9951					marlener@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	CMS Casework Communication Contact		Ms.	Bell	Yvonne		1-760-344-9951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	Coordination of Benefits Contact			Sanders	Sara		1-760-344-9951					saras@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	Customer Service Operations Contact			Sanders	Sara		1-760-344-9951					saras@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	Government Relations Contact			Sanders	Sara		1-760-344-9951					saras@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	Medicare Compliance Officer		Ms.	Bell	Yvonne		1-760-344-9951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part D Exceptions Contact			Sanders	Sara							saras@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending	1-800-465-3203				PACE - Nat		C	San Francisco
H6796	Pharmacy Network Management Contact			Slone	Jonathan		1-760-344-9951					jonathans@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6796	Pharmacy Technical Help Desk Contact			Sanders	Sara							saras@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending	1-800-465-3203				PACE - Nat		C	San Francisco
H6796	Plan to Plan Reconciliation Contact			Sanders	Sara		1-760-344-9951					saras@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2023	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H6813	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H6813	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6813	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H6813	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6815	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H6815	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6815	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H6815	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare by Health Net	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6830	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	01/31/2020	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H6830	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6830	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H6830	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY KANSAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H6832	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/23/2019	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/23/2019	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/20/2021	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/20/2021	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		1-615-481-1897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	08/10/2022	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/20/2021	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Philadelphia
H6832	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/20/2021	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6832	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Philadelphia
H6832	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6846	Automated TrOOP Balance Transfer Contact	Finance Manager	Mr.	Earley	Trey		1-828-213-8442				1-828-681-8913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Best Available Evidence Contact	Program Director	Ms.	Cone	Kirsten		1-828-213-8440					Kirsten.cone@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	12/23/2022	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Chief Financial Officer	CFO	Mr.	Groesser	Tyler		1-828-277-4818					tyler.groesser@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	08/13/2021	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	CMS Casework Communication Contact	Program Director	Ms.	Cone	Kirsten		1-828-213-8440					Kirsten.cone@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	12/23/2022	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Coordination of Benefits Contact	Finance Manager	Mr.	Earley	Trey		1-828-213-8442				1-828-681-8913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Customer Service Operations Contact	Program Director	Ms.	Cone	Kirsten		1-828-213-8442				1-828-681-8913	kirsten.cone@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	05/04/2021	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Government Relations Contact	Program Director	Ms.	Cone	Kirsten		1-828-213-8440					Kirsten.cone@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	12/23/2022	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Medicare Compliance Officer	Program Director	Ms.	Cone	Kirsten		1-828-213-8440				1-828-681-8913	kirsten.cone@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	05/04/2021	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Part D Exceptions Contact	Finance Manager	Mr.	Earley	Trey						1-828-681-8913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	03/18/2020	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active	1-828-213-8442				PACE - Nat		C	Atlanta
H6846	Pharmacy Network Management Contact	Clinical Manager	Mr.	Healy	Joseph		1-828-213-8442				1-828-681-8913	Joseph.Healy@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	05/04/2021	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Pharmacy Technical Help Desk Contact	Clinical Manager	Mr.	Healy	Joseph						1-828-681-8913	Joseph.Healy@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	01/27/2021	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active	1-800-111-2222				PACE - Nat		C	Atlanta
H6846	Plan to Plan Reconciliation Contact	Finance Manager	Mr.	Earley	Trey		1-828-213-8442				1-828-681-8913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2023	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6847	Automated TrOOP Balance Transfer Contact	Director, Pharmacy		Gallagher	Angela		1-857-282-2493					agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Best Available Evidence Contact	Director, Enrollment		Fishkin	Carly		1-857-282-2762					cfishkin@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	08/20/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Chief Financial Officer	CFO	Ms	Silva	Lucy		1-207-939-4468					lsilva@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	12/20/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	CMS Casework Communication Contact	Director, Quality		Sahar	Maurice		1-857-282-9076					msahar@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	07/06/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Coordination of Benefits Contact	Manager, Recoveries		Ryan	Cathy		1-857-282-9131					cryan@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Customer Service Operations Contact	Director, Customer Services		Biron	Jonathan		1-857-282-9082					jbiron@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Government Relations Contact	Director, Government Affairs		Sullivan	John		1-857-282-3376					jsullivan@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Hospice Contact	Director, Pharmacy		Gallagher	Angela		1-857-282-2493					agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Trembley	Shannon		1-207-939-4468					STrembley@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	09/27/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Part D Exceptions Contact	Director, Pharmacy		Gallagher	Angela							agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	1-857-282-2493				HMO - Health Maintenance Organization		C	Boston
H6847	Pharmacy Network Management Contact	Director, Pharmacy		Gallagher	Angela		1-857-282-2493					agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6847	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Gallagher	Angela							agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Boston
H6847	Plan to Plan Reconciliation Contact	Controller		Tang	Tak		1-857-282-3317					ttang@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Automated TrOOP Balance Transfer Contact	Director of Clinical Pharmacy		Smith	Ashley		1-617-478-3738					ashley.smith@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	06/14/2022	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Best Available Evidence Contact	Manager of Member Enrollment		Cason	Joseph		1-617-748-6356					joseph.cason@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	02/15/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Chief Financial Officer	Chief Financial Officer	Mr.	Collins	James		1-617-748-6384					James.Collins@BMCHP-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	01/22/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	CMS Casework Communication Contact	Director, Appeals & Grievances		Bigbee	Jacqueline		1-774-644-6922					jacqueline.bigbee@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	09/27/2022	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Coordination of Benefits Contact	Manager Of Pharmacy Operations & Contract Manager		Boyer	Nohemie		1-781-244-2649					Nohemie.Boyer@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	05/18/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Customer Service Operations Contact	Ops Mgr, Member & Provider Services		Mendez	Keyssir		1-617-748-3867					Keyssir.Mendez@BMCHP-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	11/23/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Government Relations Contact	Director of Government Affairs	Mr.	Krintzman	Josh		1-617-748-6490					Josh.Krintzman@BMCHP-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	02/15/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Hospice Contact	Director of Clinical Pharmacy		Smith	Ashley		1-617-478-3738					Ashley.Smith@bmchp.org	529 Main Street	Suite 500	Charlestown	MA	02129	02/15/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Comerford	Michael	J	1-781-962-0405					michael.comerford@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	06/24/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Part D Exceptions Contact	Director of Clinical Pharmacy		Smith	Ashley							Ashley.Smith@bmchp.org	529 Main Street	Suite 500	Charlestown	MA	02129	02/15/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	1-855-833-8125				HMO - Health Maintenance Organization		C	Boston
H6851	Pharmacy Network Management Contact	Manager Of Pharmacy Operations & Contract Manager		Boyer	Nohemie		1-781-244-2649					Nohemie.Boyer@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	05/18/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6851	Pharmacy Technical Help Desk Contact	Manager Of Pharmacy Operations & Contract Manager		Boyer	Nohemie							Nohemie.Boyer@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	12/20/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Boston
H6851	Plan to Plan Reconciliation Contact	Staff Accountant		McGinnis	Kathleen		1-781-975-2780					Kathleen.McGinnis@BMCHP-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	04/25/2022	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6852	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H6852	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6852	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H6852	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6868	Automated TrOOP Balance Transfer Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	Best Available Evidence Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	Chief Financial Officer	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	CMS Casework Communication Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	Coordination of Benefits Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	Customer Service Operations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	Government Relations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	Medicare Compliance Officer	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	Part D Exceptions Contact	CFO		Prentis	Kristin							kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending	1-732-806-3224				PACE - Nat		C	Atlanta
H6868	Pharmacy Network Management Contact	Executive Director	Mrs	Runyon	Bobbi		1-732-592-3400					brunyon@beaconpace.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6868	Pharmacy Technical Help Desk Contact	Executive Director	Mrs	Runyon	Bobbi							brunyon@beaconpace.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending	1-732-592-3400				PACE - Nat		C	Atlanta
H6868	Plan to Plan Reconciliation Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	11/29/2022	2023	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H6870	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/24/2021	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/24/2021	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/24/2021	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				Demo Risk Option C	MMP HMO Demo	C	Dallas
H6870	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	SUPERIOR HEALTHPLAN, INC.	Demo	Superior HealthPlan	Medicare-Medicaid Plan HMO/HMOPOS		Centene Corporation	351	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H6874	Automated TrOOP Balance Transfer Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	08/16/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Best Available Evidence Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					mjohnson4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/16/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Chief Financial Officer	SVP and Chief Financial Officer	Mr.	Sczygelski	Sidney		1-715-847-2603					sid.sczygelski@aspirus.org	2200 Westwood Drive, 3rd Floor		Wausau	WI	54401	02/05/2020	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	CMS Casework Communication Contact	A&G Regulatory and Compliance Specialist		Wood	Nakia		1-612-294-5668					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Coordination of Benefits Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Customer Service Operations Contact	CS Support Services Sr Manager		Vang	Pakou		1-612-676-3585					pvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Government Relations Contact	Federal Government Relations Specialist		Vang	Julie		1-612-294-5654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/30/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Hospice Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051					pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Medicare Compliance Officer	Interim Compliance & Privacy Officer	Mr.	Nemeth	James		1-715-843-1389					BPOMedicare@ucare.org	3000 Westhill Drive, Suite 303		Wausau	WI	54401	10/25/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part D Exceptions Contact	Vice President Pharmacy Management		Mitsch	Patrick						1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active	1-612-294-5051				PPO - BBA		C	Chicago
H6874	Pharmacy Network Management Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Pharmacy Technical Help Desk Contact	Director, Customer Service		Warren	Mark							mwarren@express-scripts.com	6625 West 78th Street		Minneapolis	MN	55439	07/30/2021	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H6874	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		1-612-676-3213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/15/2020	2023	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6887	Automated TrOOP Balance Transfer Contact	Finance Director	Ms.	Stevenson	Gail		1-856-362-4516					stevensong@ihn.org	2445 S. Delsea Drive		Vineland	NJ	08360	01/23/2019	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	Best Available Evidence Contact	Executive Director	Mrs.	DempseyStahl	Mia		1-856-362-4515					dempseystahlm@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	Chief Financial Officer	Executive VP and Chief FInancial Officer	Mr.	Baldosaro	Thomas		1-856-641-6605					baldosarot@ihn.org	165 Bridgeton Pike		Mullica Hill	NJ	08062	06/01/2022	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	CMS Casework Communication Contact	Executive Director	Mrs.	DempseyStahl	Mia		1-856-362-4515					dempseystahlm@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	Coordination of Benefits Contact	Finance Director	Ms.	Stevenson	Gail		1-856-362-4516					stevensong@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/23/2019	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	Customer Service Operations Contact	Executive Director	Mrs.	DempseyStahl	Mia		1-856-362-4515					dempseystahlm@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	Government Relations Contact	Executive Director	Mrs.	DempseyStahl	Mia		1-856-362-4515					dempseystahlm@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	Medicare Compliance Officer	Quality Director	Ms.	Powell	Al'Asia		1-856-362-4517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	Part D Exceptions Contact	Finance Director	Ms.	Stevenson	Gail							stevensong@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/23/2019	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active	1-855-295-5433				PACE - Nat		C	New York
H6887	Pharmacy Network Management Contact	Medical Director	Dr	Raziano	Donna		1-856-418-5433					razianod@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	11/29/2022	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6887	Pharmacy Technical Help Desk Contact	Executive Director	Mrs.	DempseyStahl	Mia							dempseystahlm@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active	1-856-362-4515				PACE - Nat		C	New York
H6887	Plan to Plan Reconciliation Contact	Finance Director	Ms.	Stevenson	Gail		1-856-362-4516					stevensong@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/23/2019	2023	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active					PACE - Nat		C	New York
H6891	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/18/2020	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H6891	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6891	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-833-674-6201				HMO - Health Maintenance Organization		C	Dallas
H6891	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6898	Automated TrOOP Balance Transfer Contact	Sr. Project Manager		Rush	Jamie		1-314-354-1103					ESITroopTransfer@express-scripts.com	One Express Way		St.Louis	MO	63121	02/05/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Best Available Evidence Contact	Manager, Enrollment and Billing		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road Suite 200		Glen Allen	VA	23060	06/17/2022	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Chief Financial Officer	SVP, Controller	Mr.	Pisarik	Jason		1-248-665-4348					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	VT	05601	02/07/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	CMS Casework Communication Contact	Compliance Consultant		White	Jasmin		1-248-665-4235					JWhite4@bcbsm.com	1000 Town Center		Southfield	MI	48075	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Coordination of Benefits Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	03/22/2022	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Customer Service Operations Contact	Director, Workforce Management, Analytics, & Supp		Weber	Julie		1-313-225-0555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/11/2021	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Government Relations Contact	Manager, Performance and Oversight		Martell	Stacey		1-313-806-5905					smartell@bcbsm.com	1000 Town Center		Southfield	MI	48075	04/16/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Hospice Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		1-954-498-5880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-614-336-3326				PPO - BBA		C	Chicago
H6898	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Healther		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St.Louis	MO	63121	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6898	Pharmacy Technical Help Desk Contact	Director of Operations, Contact Center		Liu	Ian							iliu@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H6898	Plan to Plan Reconciliation Contact	SVP, Controller		Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H6910	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		1-614-546-3183				1-614-546-3131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		1-614-546-3222				1-614-546-3148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		1-614-546-3211				1-614-546-3131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	CMS Casework Communication Contact	Compliance Specialist	Mr.	Jordan	David	A	1-614-706-8474				1-614-234-8372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Customer Service Operations Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		1-614-546-3180				1-614-546-3132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Government Relations Contact	CEO	Mr	Randolph	John	C	1-614-546-3152				1-614-546-3131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		1-412-478-0244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Part D Exceptions Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	1-800-240-3851				HMO - Health Maintenance Organization		C	Chicago
H6910	Pharmacy Network Management Contact	Director, Pharmacy	Mr	Turoff	Chris		1-614-403-0394					chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6910	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H6910	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6936	Automated TrOOP Balance Transfer Contact			Esp	Brian		1-858-790-6445					partdcat@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/12/2019	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Best Available Evidence Contact	Mgr- Medicare Enrollment		Ramirez	Michelle		1-602-916-8404					michelle.ramirez@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	05/29/2020	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Chief Financial Officer	Chief Financial Officer	Mr.	El-Tawil	Mark		1-602-864-5700					mark.el-tawil@azblue.com	8220 N 23rd Ave	MS C410	Phoenix	AZ	85021	02/12/2019	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	CMS Casework Communication Contact	Director, Corporate and Medicare Compliance		Moore	Veronica		1-602-336-7600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/29/2020	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Coordination of Benefits Contact	Mgr- Medicare Finance		Nguyen	Peter		1-602-916-8506					peter.nguyen@azblue.com	10835 N 25th Ave		Phoenix	AZ	85029	05/29/2020	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Customer Service Operations Contact	Staff VP, MA Ops & FEP Progs		Setzer	Stephanie	S	1-602-864-5726					stephanie.setzer@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	06/08/2022	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Government Relations Contact	VP & General Manager Medicare & FEP		Bowers	Krista		1-818-219-7755					krista.bowers@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	01/12/2022	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Hospice Contact	Sr Health Plan Rx Specialist		Norman	Laci		1-602-916-8577					laci.norman@azblue.com	2444 W Las Palmaritas Dr		Phoenix	AZ	85021	05/29/2020	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Medicare Compliance Officer	Director, Corporate and Medicare Compliance	Mrs.	Moore	Veronica		1-602-336-7600				1-602-864-3152	veronica.moore@azblue.com	8220 N 23rd Avenue		Phoenix	AZ	85021	02/11/2021	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Part D Exceptions Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Weideman	Stacy							Stacy.Weideman@azblue.com	10835 N 25th Ave. Ste 108		Phoenix	AZ	85029	12/16/2022	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-602-864-4391				HMO - Health Maintenance Organization		C	San Francisco
H6936	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	MedImpact	10181 Scripps Gateway Ct .	San Diego	CA	92131	02/12/2019	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6936	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct .		San Diego	CA	92131	11/16/2022	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-877-403-6038				HMO - Health Maintenance Organization		C	San Francisco
H6936	Plan to Plan Reconciliation Contact	Director, Financial Reporting		Acquafredda	Brandy		1-602-864-4683				1-602-864-5308	brandy.acquafredda@azblue.com	PO Box 81049		Phoenix	AZ	85069	03/09/2020	2023	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H6941	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mr	Copeland	Bill		1-918-664-9000				1-918-664-9922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Best Available Evidence Contact	Senior Director	Mrs.	Blue	Samantha		1-918-664-9000	1124				sblue@lifeseniorservices.org	5330 E. 31st Street, Suite 800		Tulsa	OK	74135	12/09/2022	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Chief Financial Officer	Chief Financial Officer	Mr	Copeland	Bill		1-918-664-9000				1-918-664-9922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	CMS Casework Communication Contact	PACE Program Director	Ms	Blue	Samantha		1-918-664-9000	1224				sblue@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Coordination of Benefits Contact	Chief Financial Officer	Mr	Copeland	Bill		1-918-664-9000				1-918-664-9922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Customer Service Operations Contact	PACE Program Director	Ms	Blue	Samantha		1-918-664-9000	1224				sblue@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Government Relations Contact	Senior Director	Mrs.	Blue	Samantha		1-918-664-9000	1124				sblue@lifeseniorservices.org	5330 E. 31st Street, Suite 800		Tulsa	OK	74135	12/09/2022	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Medicare Compliance Officer	Compliance Officer	Mrs,	Crow	Mary		1-918-664-9000					mcrow@lifeseniorservices.org	5330 E. 31st Street, Suite 800		Tulsa	OK	74135	12/09/2022	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Part D Exceptions Contact	Chief Financial Officer	Mr	Copeland	Bill						1-918-664-9922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active	1-866-664-9009				PACE - Nat		C	Dallas
H6941	Pharmacy Network Management Contact	COO		Greenhalgh	Michael		1-888-974-2763				1-856-273-0135	mgreenhalgh@trhc.com	CareKinesis, Inc.	228 Strawbridge Drive	Moorestown	NJ	08057	12/09/2022	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Pharmacy Technical Help Desk Contact	COO		Greenhalgh	Michael						1-856-273-0135	mgreenhalgh@trhc.com	CareKinesis, Inc.	228 Strawbridge Drive	Moorestown	NJ	08057	12/09/2022	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active	1-888-974-2763				PACE - Nat		C	Dallas
H6941	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Copeland	Bill		1-918-664-9000				1-918-664-9922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2023	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6959	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/24/2019	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Chief Financial Officer	CFO, ISNP Ventures, LLC	Mr.	Finglass	Brian		1-410-766-1995	114			1-410-505-1525	finglassb@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	03/26/2019	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/24/2019	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/06/2021	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/06/2021	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Medicare Compliance Officer	Chief Compliance Officer, ISNP Ventures, LLC	Ms.	O'Shea	Holly		1-410-766-1995	114				compliance@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	10/08/2019	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/15/2021	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Philadelphia
H6959	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/13/2021	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6959	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Philadelphia
H6959	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6975	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H6975	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6975	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H6975	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE OF ALABAMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6988	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		1-858-790-6250				1-858-790-6052	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/29/2020	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Best Available Evidence Contact	MA-PD Enrollment Supervisor		Thompkins	Alicia		1-718-215-7000	3750			1-718-581-5552	AThompkins@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	06/04/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Chief Financial Officer	Chief Financial Officer		Stender	Steven		1-917-831-3102					sstender@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	07/07/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	CMS Casework Communication Contact	Director of Regulatory Compliance		Ng	Wendy		1-917-993-6647					wng@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	07/07/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Coordination of Benefits Contact	Senior Director of Finance		Engelberg	Gila		1-718-215-7000	3301				GEngelberg@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	04/16/2022	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Customer Service Operations Contact	VP of Health Plan Operations		Yanofsky	Adam		1-347-305-7937					ayanofsky@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	07/07/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Government Relations Contact	Chief Compliance Officer		Faust	Lois		1-718-215-7000	3104				compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	07/07/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Hospice Contact	Director of Pharmacy Management		Segal	Penina		1-718-215-7000	3221				psegal@centersplan.com	75 Vanderbilt Avenue	Ste. 700	Staten Island	NY	10304	07/07/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Medicare Compliance Officer	Chief Compliance Officer		Faust	Lois		1-917-831-3104					compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	07/07/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Part D Exceptions Contact	Director of Pharmacy Management		Segal	Penina							psegal@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	07/07/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active	1-718-215-7000	3221			HMO - Health Maintenance Organization		C	New York
H6988	Pharmacy Network Management Contact	Director of Configuration Services		Moe	Kathlene		1-858-790-7437					kathlene.moe@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/05/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6988	Pharmacy Technical Help Desk Contact	VP, Customer Contact Services		Battle	Dorry						1-858-790-6075	Customerservice@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/27/2016	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active	1-888-807-5717				HMO - Health Maintenance Organization		C	New York
H6988	Plan to Plan Reconciliation Contact	Senior Director of Finance		Engelberg	Gila		1-718-215-7000	3301				GEngelberg@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	07/07/2021	2023	CENTERS PLAN FOR HEALTHY LIVING, LLC	Local CCP	Centers Plan for Healthy Living	HMO/HMOPOS		Centers Plan for Healthy Living, LLC	514	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7003	Automated TrOOP Balance Transfer Contact	Health Plan Manager	Mrs.	Boyle	Amanda		1-402-829-2993				1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	Best Available Evidence Contact	Health Plan Manager	Mrs.	Boyle	Amanda		1-402-829-2993				1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	Chief Financial Officer	CFO	Mr	Bear	Scott		1-402-829-2922				1-402-829-2939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	03/22/2018	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	CMS Casework Communication Contact	VP of PACE Operations	Mrs	Butterfield	April		1-402-829-2900				1-402-829-2998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	Coordination of Benefits Contact	Health Plan Manager	Mrs.	Boyle	Amanda		1-402-829-2993				1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	Customer Service Operations Contact	VP of PACE Operations	Mrs	Butterfield	April		1-402-829-2900				1-402-829-2998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	Government Relations Contact	Corporate Compliance Officer	Mr	Kuenning	Adam		1-402-829-2931					akuenning@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/25/2021	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	Medicare Compliance Officer	Corporate Compliance Officer	Mrs	Durbin	Tracy		1-402-829-2968				1-402-829-2939	Tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	Part D Exceptions Contact	Health Plan Manager	Mrs.	Boyle	Amanda						1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/25/2021	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active	1-000-000-0000				PACE - Nat		C	Kansas City
H7003	Pharmacy Network Management Contact	Medical Director	Mr	Vossen	Adam		1-402-829-6950				1-402-829-2998	avossen@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/16/2018	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7003	Pharmacy Technical Help Desk Contact	Health Plan Manager	Mrs.	Boyle	Amanda						1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active	1-000-000-0000				PACE - Nat		C	Kansas City
H7003	Plan to Plan Reconciliation Contact	Health Plan Manager	Mrs.	Boyle	Amanda		1-402-829-2993				1-402-829-2998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	04/23/2019	2023	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	Kansas City
H7006	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		1-858-790-6445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Best Available Evidence Contact	Enrollment Manager		Vredenburg	Cristi		1-541-492-5119					Cristi.vredenburg@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	08/04/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Chief Financial Officer	Chief Financial Officer	Mr.	Desai	Roshan		1-727-251-8934				1-503-584-1772	Roshan.Desai@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	05/18/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	CMS Casework Communication Contact	Enrollment Manager		Vredenburg	Cristi		1-541-492-5119					Cristi.vredenburg@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	08/04/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Coordination of Benefits Contact	Chief Operations Officer	Ms.	Regalado	Mae		1-951-206-7316					mae.regalado@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	03/04/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Customer Service Operations Contact	Chief Operations Officer	Ms.	Regalado	Mae		1-951-206-7316					mae.regalado@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	03/04/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Government Relations Contact	Chief Compliance Officer		Flynn	Jordan		1-602-692-4381				1-503-584-1772	Jordan.flynn@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	07/08/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Hospice Contact	VP of Pharmacy Operations	Ms.	Liu	Helen		1-970-712-9377					helen.liu@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	12/08/2022	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Flynn	Jordan		1-602-692-4381				1-503-584-1772	Jordan.flynn@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	07/08/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Part D Exceptions Contact	Director of Appeals and Grievances		Vaughn	Sara						1-541-672-8670	sara.vaughn@atriohp.com	2965 Ryan Drive SE		Salem	OR	97301	11/11/2020	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	1-877-672-8620	3			PPO - BBA		C	Seattle
H7006	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/13/2019	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7006	Pharmacy Technical Help Desk Contact	Director, Contact Center Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/13/2018	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	1-800-681-9571				PPO - BBA		C	Seattle
H7006	Plan to Plan Reconciliation Contact	Chief Financial Officer		Desai	Roshan		1-727-251-8934				1-503-584-1772	Roshan.Desai@atriohp.com	2965 Ryan Dr SE		Salem	OR	97301	05/18/2021	2023	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Seattle
H7020	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H7020	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H7020	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7027	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Gadia	Ryan		1-773-640-5792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	Best Available Evidence Contact	VP of Strategy and Business Development		Ortolaza-Alvear	Heidi		1-773-640-5786					hortolaza@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	Chief Financial Officer	Chief Financial Officer	Mr.	Gadia	Ryan		1-773-640-5792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	CMS Casework Communication Contact	VP of Strategy and Business Development		Ortolaza-Alvear	Heidi		1-773-640-5786					hortolaza@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	Coordination of Benefits Contact	Chief Financial Officer		Gadia	Ryan		1-773-640-5792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	Customer Service Operations Contact	VP of Strategy and Business Development		Ortolaza-Alvear	Heidi		1-773-640-5786					hortolaza@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	Government Relations Contact	Director of Foundation and Government Relations		Hayford	Justin		1-773-828-8270					jhayford@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	Medicare Compliance Officer	Chief Financial Officer	Mr.	Gadia	Ryan		1-773-640-5792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	Part D Exceptions Contact	VP of Strategy and Business Development		Ortolaza-Alvear	Heidi							hortolaza@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending	1-773-584-6200				PACE - Nat		C	Chicago
H7027	Pharmacy Network Management Contact	VP of Strategy and Business Development		Ortolaza-Alvear	Heidi		1-773-640-5786					hortolaza@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7027	Pharmacy Technical Help Desk Contact	VP of Strategy and Business Development		Ortolaza-Alvear	Heidi							hortolaza@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending	1-773-584-6200				PACE - Nat		C	Chicago
H7027	Plan to Plan Reconciliation Contact	Chief Financial Officer		Gadia	Ryan		1-773-640-5792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2023	ESPERANZA HEALTH CENTERS	National PACE	Esperanza Health Centers	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7028	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H7028	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7028	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H7028	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7059	Automated TrOOP Balance Transfer Contact	Program Director		Coseo	Robert		1-941-586-7353					rcoseo@stratumhealthsystem.org	5955 Rand Boulevard		Sarasota	FL	34238	03/26/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	Best Available Evidence Contact	Program Director		Coseo	Robert		1-941-586-7353					rcoseo@stratumhealthsystem.org	5955 Rand Boulevard		Sarasota	FL	34238	03/26/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	Chief Financial Officer	CFO/COO	Ms.	Bouhamid	Saida		1-941-552-7599					sbouhamid@tidewell.org	5955 Rand Blvd.		Sarasota	FL	34238	03/22/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	CMS Casework Communication Contact	Program Director		Coseo	Robert		1-941-586-7353					rcoseo@stratumhealthsystem.org	5955 Rand Boulevard		Sarasota	FL	34238	03/26/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	Coordination of Benefits Contact	Program Director		Coseo	Robert		1-941-586-7353					rcoseo@stratumhealthsystem.org	5955 Rand Boulevard		Sarasota	FL	34238	03/26/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	Customer Service Operations Contact	Program Director		Coseo	Robert		1-941-586-7353					rcoseo@stratumhealthsystem.org	5955 Rand Boulevard		Sarasota	FL	34238	03/26/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	Government Relations Contact	Program Director		Coseo	Robert		1-941-586-7353					rcoseo@stratumhealthsystem.org	5955 Rand Boulevard		Sarasota	FL	34238	03/26/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	Medicare Compliance Officer		Mr.	Weldy	Alan		1-574-312-4267					Aweldy@stratumhealthsystem.org	5955 Rand Blvd		Sarasota	FL	34238	03/22/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	Part D Exceptions Contact			Coseo	Robert							rcoseo@stratumhealthsystem.org	5955 Rand Blvd		Sarasota	FL	34238	03/22/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending	1-855-787-8655				PACE - Nat		C	Atlanta
H7059	Pharmacy Network Management Contact			Jolly	Donna		1-941-552-7571					djolly@tidewell.org	5955 Rand Blvd		Sarasota	FL	34238	03/22/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7059	Pharmacy Technical Help Desk Contact			Brown	Jenifer								5955 Rand Blvd		Sarasota	FL	34238	03/22/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending	1-855-787-8655				PACE - Nat		C	Atlanta
H7059	Plan to Plan Reconciliation Contact	Program Director		Coseo	Robert		1-941-586-7353					rcoseo@stratumhealthsystem.org	5955 Rand Boulevard		Sarasota	FL	34238	03/26/2021	2023	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H7063	Automated TrOOP Balance Transfer Contact	Manager PBM Operations	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/10/2022	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Best Available Evidence Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		1-785-291-8592					janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629-0001	02/03/2020	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Chief Financial Officer	Chief Financial Officer	Mr	Bergman	Jeff		1-785-291-7263				1-785-291-8465	jeff.bergman@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629-0001	06/01/2022	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	CMS Casework Communication Contact	Compliance Officer		English	Chris		1-785-291-8078					compliance@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	66629-0001	02/03/2020	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Coordination of Benefits Contact	Manager PBM Operations	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBmedd@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/10/2022	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Customer Service Operations Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		1-785-291-8592				1-785-290-0733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629-0001	10/25/2019	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Government Relations Contact	VP Government & Community Relations		Mickle	Sunee		1-785-291-7194					sunee.mickle@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	66629-0001	04/17/2019	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Hospice Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		1-785-291-8592				1-785-290-0733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629-0001	10/25/2019	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Medicare Compliance Officer	Compliance Officer	Mr.	English	Chris		1-785-213-1767					chris.english@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629-0001	11/10/2022	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Part D Exceptions Contact	Director Regulatory and Audit Response	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/15/2020	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active	1-877-277-5449	3			PPO - BBA		C	Kansas City
H7063	Pharmacy Network Management Contact	AVP Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/15/2020	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7063	Pharmacy Technical Help Desk Contact	Manager Member Services, Prime		Garza-Rodriguez	Melissa							MGarzarodriguez@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	01/22/2020	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active	1-866-325-5231				PPO - BBA		C	Kansas City
H7063	Plan to Plan Reconciliation Contact	Staff Accountant		Zen	Kayla-Ann		1-785-291-8208				1-785-290-0733	Kayla-ann.zen@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629-0001	07/06/2022	2023	BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.	Local CCP	Blue Cross and Blue Shield of Kansas	Local PPO		Blue Cross Blue Shield of Kansas	310	Yes	Active					PPO - BBA		C	Kansas City
H7074	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	02/15/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/09/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				PPO - BBA		C	San Francisco
H7074	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	03/31/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7074	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/21/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				PPO - BBA		C	San Francisco
H7074	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	02/15/2021	2023	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H7076	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		1-937-818-7479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Best Available Evidence Contact	Enrollment Team Lead	Mr.	Richardson	Kal		1-937-224-3300	3437			1-937-425-0909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	01/16/2020	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Chief Financial Officer	Chief Financial Officer	Mr.	Smart	Lawrence		1-937-531-3335					Lawrence.Smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/05/2021	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	CMS Casework Communication Contact	Director, Grievance and Appeals	Ms.	Acuna	Celeste		1-480-640-6815					celeste.acuna@caresource.com	P.O. Box 1947		Dayton	OH	45401	01/20/2022	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Coordination of Benefits Contact	Manager, Enrollment Operations	Mr.	Spivey	Michael		1-937-531-3682				1-937-487-0643	COBInquiry@caresource.com	230 N. Main St.		Dayton	OH	45402	04/15/2022	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Customer Service Operations Contact	Director, Customer Care		Cary	Lisa		1-937-232-6458					lisa.cary@caresource.com	40 W 2nd St		Dayton	OH	45402	10/04/2021	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Government Relations Contact	Director, Medicare Compliance Officer	Ms.	de Cardenas	Deonys		1-678-471-0101					deonys.decardenas@caresource.com	230 North Main Street		Dayton	OH	45402	05/04/2021	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Hospice Contact	Director, Enrollment	Mr.	Castro	Armando		1-937-531-2291					armando.castro@caresource.com	230 N Main St		Dayton	OH	45402	05/29/2020	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	de Cardenas	Deonys		1-678-471-0101					deonys.decardenas@caresource.com	230 N. Main St.		Dayton	OH	45402	05/04/2021	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/08/2022	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	New York
H7076	Pharmacy Network Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		1-937-818-7479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7076	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/22/2021	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H7076	Plan to Plan Reconciliation Contact	Manager, Accounting	Ms.	North	Sara		1-937-531-2669					CareSourceP2P@caresource.com	CareSource Accounting	PO Box 2208	Dayton	OH	45401	08/26/2020	2023	CARESOURCE INDIANA, INC.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7093	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/07/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/10/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Part D Exceptions Contact	Medical Director, MD Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	01/21/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H7093	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-557-6384					raymond.warner@ingenio-rx.com	4553 La Tienda Drive	CAT101-A009	Thousand Oaks	CA	91362	01/21/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H7093	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2023	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7114	Automated TrOOP Balance Transfer Contact	PACE Director		Tilford	Christina		1-405-609-3688					christina.tilford@valir.com	700 NW 7th St		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Best Available Evidence Contact	PACE Director		Tilford	Christina		1-405-609-3688					christina.tilford@valir.com	700 NW 7th St		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Chief Financial Officer		Mr	Cummings	Chris		1-405-609-3688					chris.cummings@valir.com	700 NW 7th St		Oklahoma City	OK	73102	09/20/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	CMS Casework Communication Contact	PACE President	Mr.	Brownlow	Jake		1-405-609-3688					jake.brownlow@valir.com	700 NW 7th St		Oklahoma City	OK	73102	08/16/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Coordination of Benefits Contact	Site Director		Tilford	Christina		1-405-609-3688					christina.tilford@valir.com	721 NW 6th St		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Customer Service Operations Contact	Director of QI and Compliance	Mrs	Coleman	Monica		1-405-609-3688					monica.coleman@valir.com	721 NW 6th		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Government Relations Contact	Director of QI and Compliance	Mrs	Coleman	Monica		1-405-609-3688					monica.coleman@valir.com	721 NW 6th St		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Medicare Compliance Officer	Director of QI and Compliance	Mrs	Coleman	Monica		1-405-609-3688					monica.coleman@valir.com	721 NW 6th		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part D Exceptions Contact	Site Director		Tilford	Christina							christina.tilford@valir.com	700 NW 7th St		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active	1-405-609-3688				PACE - Nat		C	Dallas
H7114	Pharmacy Network Management Contact	Medical Director	Dr	Krablin	Brett		1-405-609-3688					brett.krablin@valir.com	721 NW 6th		Oklahoma City	OK	73102	05/17/2021	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Pharmacy Technical Help Desk Contact	Site Director		Tilford	Christina							christina.tilford@valir.com	700 NW 7th St		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active	1-405-609-3688				PACE - Nat		C	Dallas
H7114	Plan to Plan Reconciliation Contact	Site Director		Tilford	Christina		1-405-609-3688					christina.tilford@valir.com	700 NW 7th St		Oklahoma City	OK	73102	07/11/2022	2023	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7115	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment and Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	1025 West Navitus Dr		Appleton	WI	54913	06/08/2021	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Best Available Evidence Contact	AVP, Sales and Marketing		Tinsey	Mark		1-615-218-2867					mark.tinsey@apex4health.com	929 Gessner #1510		Houston	TX	77024	08/18/2022	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Chief Financial Officer	Chief Financial Officer	Ms.	Petersen	Heather		1-713-338-6429					heather.petersen@apex4health.com	929 Gessner, Suite 1900		Houston	TX	77024	08/18/2022	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	CMS Casework Communication Contact	AVP, Sales & Marketing		Tinsey	Mark		1-615-218-2867					mark.tinsey@apex4health.com	929 Gessner #1510		Houston	TX	77024	08/18/2022	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Coordination of Benefits Contact	Manager, Eligibility & Enrollment		Ray	Trevor		1-318-355-0478					trevor.ray@apex4health.com	929 Gessner, Suite 1500		Houston	TX	77024	08/18/2022	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Customer Service Operations Contact	VP, Health Plan Operations		Barnard	Ilsa		1-713-338-6349					ilsa.barnard@apex4health.com	929 Gessner 1500		Houston	TX	77024	09/08/2022	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Government Relations Contact	Chief Executive Officer		Hurt	Jay		1-713-338-6165					Jay.Hurt2@memorialhermann.org	929 Gessner #1500		Houston	TX	77024	09/08/2022	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Hospice Contact	VP of Health Services	Ms.	Douds	Claudia		1-713-338-6492					claudia.douds@apex4health.com	929 Gessner Suite 1500		Houston	TX	77024	08/18/2022	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Medicare Compliance Officer	VP, Compliance	Mr.	Clark	Robert		1-713-338-6429					robert.clark@memorialhermann.org	929 Gessner, Suite 1500		Houston	TX	77024	12/31/2020	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Part D Exceptions Contact	Sr. Manager, Clinical Prior Authorization		LeClair	Christophe							Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/08/2021	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Denver
H7115	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688					Jan.Robinson@navitus.com	361 Integrity Drive		Madison	WI	53713	02/17/2021	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7115	Pharmacy Technical Help Desk Contact	Sr Manager, Cust Svce Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/08/2021	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Denver
H7115	Plan to Plan Reconciliation Contact	Director, Finance		Powell	John		1-713-338-6439					john.powell@apex4health.com	929 Gessner	Suite 1500	Houston	TX	77024	08/18/2022	2023	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7123	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		1-412-454-5539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		1-412-454-5559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	CMS Casework Communication Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		1-412-454-5250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		1-412-454-7664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		1-412-454-8589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	1-800-396-4139				HMO - Health Maintenance Organization		C	Philadelphia
H7123	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/16/2019	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7123	Pharmacy Technical Help Desk Contact	DIrector, Customer Service		Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	07/29/2021	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Philadelphia
H7123	Plan to Plan Reconciliation Contact	Business Analyst II		Michalski	Jeff		1-412-454-5715				1-412-454-2110	medicarereporting@upmc.edu	c/o UPMC Health Plan Attn: Dave Soltesz P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	10/03/2022	2023	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7147	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H7147	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7147	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H7147	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7149	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-888-736-9118				1-888-554-7668	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/03/2018	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/15/2020	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H7149	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7149	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H7149	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H7151	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H7151	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7151	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H7151	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7163	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Best Available Evidence Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Chief Financial Officer	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	CMS Casework Communication Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Coordination of Benefits Contact	Medicare Enrollment Supervisor	Mrs.	Drake	Michele		1-318-998-3083					mdrake@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Customer Service Operations Contact	Director of Member Services	Mrs.	Trichel	Amy		1-318-998-2870					atrichel@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Government Relations Contact	Deputy General Counsel	Mrs.	Harvey	Korey		1-225-297-2762					korey.harvey@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Hospice Contact	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Miller	Wesley		1-225-298-7965					Wesley.Miller@bcbsla.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Part D Exceptions Contact	Director of Pharmacy	Mr.	Dearman	Clyde							cdearman@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-318-998-2710				HMO - Health Maintenance Organization		C	Dallas
H7163	Pharmacy Network Management Contact	Associate Director Pharmacy Network Management		Burdick	Tammy		1-920-221-4089					Tammy.Burdick@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7163	Pharmacy Technical Help Desk Contact	Pharmacy Director	Mr.	Dearman	Clyde							cdearman@vhpla.com	130 DeSiard St Suite 300		monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	1-866-704-0109				HMO - Health Maintenance Organization		C	Dallas
H7163	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mrs.	Cupit	Chelle		1-318-998-3076					ccupit@vhpla.com	130 DeSiard St	Suite 300	Monroe	LA	71201	12/22/2022	2023	VANTAGE HEALTH PLAN OF MISSISSIPPI, INC.	Local CCP	Vantage Health Plan	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7165	Automated TrOOP Balance Transfer Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Best Available Evidence Contact	Director Operations		Ortiz	Jason		1-803-264-3910				1-803-264-9581	Jason.Ortiz@BCBSSC.MA.Compliance	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Chief Financial Officer	VP & CFO, BCBS Div	Mrs.	Srulevich	Heather		1-803-264-9488					Heather.Srulevich@BCBSSC.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	10/26/2017	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	CMS Casework Communication Contact	Manager - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Coordination of Benefits Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/23/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Customer Service Operations Contact	Director Operations		Ortiz	Jason		1-803-264-3910					jason.ortiz@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Government Relations Contact	Compliance Officer		Pierstorff	Joel		1-803-264-1971				1-803-264-4050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Hospice Contact	Supervisor - Medicare Advantage Operations		DeWitt	Tanika		1-803-264-1103					tanika.dewitt@bcbssc.com	1-20 @ Alpine Rd.	AG-780	Columbia	SC	29223	10/25/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Medicare Compliance Officer	Compliance Officer	Mr.	Pierstorff	Joel		1-803-606-2211				1-803-264-4050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 @ Alpine Rd, Mailcode AC-200	AC-200	Columbia	SC	29219	01/05/2022	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Part D Exceptions Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris						1-803-870-8162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active	1-803-264-4347				HMO - Health Maintenance Organization		C	Atlanta
H7165	Pharmacy Network Management Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		1-803-264-4347				1-803-870-8162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7165	Pharmacy Technical Help Desk Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris							Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/31/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active	1-855-540-5951				HMO - Health Maintenance Organization		C	Atlanta
H7165	Plan to Plan Reconciliation Contact	Banking Supervisor		Craft	Jennifer		1-803-264-3430				1-803-870-8623	EFT.Request@bcbssc.com	I-20 at Alpine Road	AX-A30	Columbia	SC	29219	12/27/2016	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	HMO/HMOPOS		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7169	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/02/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H7169	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7169	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H7169	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7172	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Best Available Evidence Contact	Lead Director, Compliance		Brown	Kristen	J	1-614-439-5370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	07/15/2022	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	05/04/2020	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	CMS Casework Communication Contact	Lead Director		Leskovac	Tara		1-614-563-7807					leskovact@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/20/2022	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Coordination of Benefits Contact	Phamacy Director		Vergil	Gina		1-402-699-7768					VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	04/12/2017	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		1-866-600-2139					PhillipsL1@aetna.com	7400 Camous Road		New Albany	OH	43054	01/21/2020	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Government Relations Contact	Vice President, Duals Markets	Mr	Smith	Jason		1-614-551-4237					SmithT25@aetna.com	4500 E. Cotton Center Blvd.		Phoenix	AZ	85040	01/14/2022	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Hospice Contact	Director, Service Operations		Truitt	Michelle		1-717-671-6847					MLTruitt@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	07/01/2020	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Part D Exceptions Contact	Phamacy Director		Vergil	Gina							VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	04/12/2017	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-402-699-7768				Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Pharmacy Network Management Contact	Pharmacy Director		Nkurunziza	Natalie		1-860-900-6247					NkurunzizaN@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	09/20/2022	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Pharmacy Technical Help Desk Contact	Phamacy Director		Nkurunziza	Natalie							NkurunzizaN@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	09/20/2022	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-855-364-2974				Demo Risk Option C	MMP HMO Demo	C	Chicago
H7172	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA BETTER HEALTH INC. (OH)	Demo	Aetna Better Health of Ohio, MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7175	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H7175	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7175	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H7175	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7195	Automated TrOOP Balance Transfer Contact	CEO	Mrs.	Grimm	Lynn		1-701-250-0709	103			1-701-250-0739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	Best Available Evidence Contact	CEO	Mrs.	Grimm	Lynn		1-701-250-0709	103			1-701-250-0739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	Chief Financial Officer	CEO	Mrs.	Grimm	Lynn	M	1-701-250-0709	102			1-701-250-0739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	CMS Casework Communication Contact	CEO	Mrs.	Grimm	Lynn	M	1-701-250-0709	102			1-701-250-0739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	Coordination of Benefits Contact	CEO	Mrs.	Grimm	Lynn		1-701-250-0709	103			1-701-250-0739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	Customer Service Operations Contact	Compliance Manager	Mrs.	Harrison	Marlys		1-701-751-3050	121			1-701-751-3053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	Government Relations Contact	CEO	Mrs.	Grimm	Lynn		1-701-250-0709	103			1-701-250-0739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	Medicare Compliance Officer	Compliance Manager	Mrs.	Harrison	Marlys		1-701-751-3050	121			1-701-751-3053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	Part D Exceptions Contact	Compliance Manager	Mrs.	Harrison	Marlys						1-701-751-3053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active	1-888-883-8959	121			PACE - Nat		C	Dallas
H7195	Pharmacy Network Management Contact	Compliance Manager	Mrs.	Harrison	Marlys		1-701-751-3050	121			1-701-751-3053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7195	Pharmacy Technical Help Desk Contact	Compliance Manager	Mrs.	Harrison	Marlys						1-701-751-3053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active	1-888-883-8959	121			PACE - Nat		C	Dallas
H7195	Plan to Plan Reconciliation Contact	CEO	Mrs.	Grimm	Lynn	M	1-701-250-0709					lgrimm@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	02/16/2022	2023	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	Dallas
H7199	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H7199	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H7199	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7220	Automated TrOOP Balance Transfer Contact	Executive Director -Pharmacy		Johnson	H Chris		1-317-963-4844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Best Available Evidence Contact	Member Services Director		Barrow	Nina		1-317-963-2591					nbarrow1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Chief Financial Officer	Chief Financial Officer		Black	Scott		1-317-962-1022					sblack@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	08/17/2021	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	CMS Casework Communication Contact	Compliance Consultant		Roach	Denise		1-317-963-9832					dbogardus@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Coordination of Benefits Contact	Member Services Director		Barrow	Nina		1-317-962-2591					nbarrow1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Customer Service Operations Contact	Executive Director		Johnson	Renea		1-317-963-4988					rjohnson37@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Government Relations Contact	Vice President of Legal, Compliance and Regulatory		Korty	Tina		1-317-319-5701					tkorty@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/21/2021	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Hospice Contact	Compliance Consultant		Chadd	Tammy		1-317-963-1915					tchadd@iuhealth.org	950 N Meridian St, 4th floor		Indianapolis	IN	46204	04/29/2022	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Medicare Compliance Officer	Vice President of Legal and Compliance	.	Korty	Tina		1-317-319-5701				1-317-963-9800	tkorty@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	04/05/2022	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Exceptions Contact	Manager - Pharmacy Government Programs		Scarpino	Christine							PartDOps@evolenthealth.com	800 N Glebe Rd	Suite 500	Arlington	VA	22203	12/29/2020	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active	1-866-823-1016				HMO - Health Maintenance Organization		C	Chicago
H7220	Pharmacy Network Management Contact	Executive Director -Pharmacy		Johnson	H Chris		1-317-963-4844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Pharmacy Technical Help Desk Contact			Rolland	Karen							KRolland@evolenthealth.com	800 N Glebe Rd	Suite 500	Arlington	VA	22203	12/14/2020	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H7220	Plan to Plan Reconciliation Contact	Finance Manager		Swayze	Robert		1-317-962-4059				1-317-963-9800	rswayze@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	04/05/2022	2023	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	Local CCP	Indiana University Health Plans	HMO/HMOPOS		Indiana University Health	379	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7245	Automated TrOOP Balance Transfer Contact	Director PBM Operations	Ms.	Barnhart	Lisa		1-513-317-6662					lisa.barnhart@advantasure.com	Advantasure, Inc.	134 Turnpike Road	Southborough	MA	01772	12/23/2020	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Best Available Evidence Contact	Senior Manager, Medicare Operations	Ms.	Browne	Kris		1-425-918-4213					kris.browne@premera.com	Premera Blue Cross	7001 220th St. SW	Mountlake Terrace	WA	98043	08/20/2019	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Chief Financial Officer	EVP, Chief Financial Officer	Mr.	Risse	Thomas		1-425-918-3926					thomas.risse@premera.com	Premera Blue Cross	7001 220th St. SW	Mountlake Terrace	WA	98043	10/02/2020	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	CMS Casework Communication Contact	Sr. Med Adv Compliance Program Adm	Ms.	Connolly	Shawnna		1-425-918-3867				1-425-918-4163	shawnna.connolly@premera.com	Premera Blue Cross	7001 220th St. SW, MS 221	Mountlake Terrace	WA	98043	04/21/2022	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Coordination of Benefits Contact	Enrollment and COB Manager	Ms.	LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	Advantasure, Inc.	1000 Town Center, 15th floor	Southfield	MI	48073	04/26/2022	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Customer Service Operations Contact	Manager	Ms.	Woods	Remy		1-313-225-7369					rwoods2@bcbsm.com	Advantasure, Inc.	4121 Cox Road, Ste. 200	Glen Allen	VA	23060	11/15/2022	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Government Relations Contact	Medicare Compliance Officer	Ms.	Badgley	Jennifer		1-425-918-5400				1-425-918-4163	jennifer.badgley@premera.com	Premera Blue Cross	7001 220th St. SW, MS 221	Mountlake Terrace	WA	98043	11/08/2018	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Hospice Contact	Pharmacy Manager, Clinical Programs	Ms.	Polzin	Jennifer		1-425-381-8236					jennifer.polzin@premera.com	Premera Blue Cross	7001 220th St. SW	Mountlake Terrace	WA	98043	09/16/2020	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Badgley	Jennifer		1-425-918-5400				1-425-918-4163	jennifer.badgley@premera.com	Premera Blue Cross	7001 220th St. SW, MS 221	Mountlake Terrace	WA	98043	11/08/2018	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Part D Exceptions Contact	Clnical Pharmacist	Ms.	Wiff	Roy							roy.wiff@advantasure.com	Advantasure, Inc.	4121 Cox Road, Ste. 200	Glen Allen	VA	23060	04/26/2022	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active	1-614-439-9079				HMO - Health Maintenance Organization		C	Seattle
H7245	Pharmacy Network Management Contact	Pharmacy Manager	Ms.	Polzin	Jennifer		1-425-918-6350					jennifer.polzin@premera.com	Premera Blue Cross	7001 220th St. SW	Mountlake Terrace	WA	98043	05/08/2020	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7245	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy								CVS Health	9501 E. Shea Blvd.	Scottsdale	AZ	85260	01/02/2018	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Seattle
H7245	Plan to Plan Reconciliation Contact	Director - Actuarial Services	Mr.	Allard	Gilbert		1-425-918-5357					gilbert.allard@premera.com	Premera Blue Cross Attn: P2P	P.O. Box 91060	Seattle	WA	98111	03/02/2020	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7262	Automated TrOOP Balance Transfer Contact	PACE Community Relations Director	Ms.	Morelli	Selina		1-303-604-5356					SelinaMorelli@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/26/2022	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	Best Available Evidence Contact	PACE Executive Director	Ms.	Black	Samantha		1-303-604-5233					samanthablack@trucare.org	2593 Park Lane		Lafayette	CO	80026	06/18/2018	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	Chief Financial Officer	VP/Chief Financial Officer	Mr.	Gresser	Scott		1-303-604-5241				1-303-604-5392	scottgresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	02/13/2017	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	CMS Casework Communication Contact	PACE Executive Director		Black	Samantha		1-303-665-0115	223				SamanthaBlack@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/17/2022	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	Coordination of Benefits Contact	PACE Community Relations Manager	Ms.	Morelli	Selina		1-303-604-5356				1-303-415-3451	SelinaMorelli@trucare.org	2593 Park Lane		Lafayette	CO	80026	09/03/2020	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	Customer Service Operations Contact	PACE Executive Director		Black	Samantha		1-303-604-5233					samanthablack@trucare.org	2593 Park Lane		Lafayette	CO	80026	01/29/2018	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	Government Relations Contact	PACE Executive Director		Black	Samantha		1-303-604-5233					samanthablack@trucare.org	2593 Park Lane		Lafayette	CO	80026	01/29/2018	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	Medicare Compliance Officer	QA/Compliance Manager	Ms.	Salinas	Laura		1-303-926-4757					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/31/2022	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	Part D Exceptions Contact	VP/Chief Financial Officer		Gresser	Scott							scottgresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	11/27/2017	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active	1-303-604-5241				PACE - Nat		C	Denver
H7262	Pharmacy Network Management Contact	CMO	Dr.	Wensel	David		1-303-926-4733					DavidWensel@trucare.org	2593 Park Lane		Lafayette	CO	80026	03/12/2021	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7262	Pharmacy Technical Help Desk Contact	PACE Medical Director	Dr.	Grushan	Marc							MarcGrushan@trucare.org	2593 Park Lane		Lafayette	CO	80026	03/12/2021	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active	1-303-415-3471				PACE - Nat		C	Denver
H7262	Plan to Plan Reconciliation Contact	VP/Chief Financial Officer		Gresser	Scott		1-303-604-5241				1-303-604-5392	scottgresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	02/14/2017	2023	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	Denver
H7273	Automated TrOOP Balance Transfer Contact	Supervisor Financial Analysis Consultant	Mr	Marshall	Gregory		1-480-684-5209					Gregory.Marshall@bannerhealth.com	2901 N. Central Ave Ste. 160		Phoenix	AZ	85012	12/27/2021	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Best Available Evidence Contact	Medicare Enrollment Sr. Mgr.	Mrs	Paredes	Nadya		1-520-874-5964				1-520-874-7083	Nadya.Paredes@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	02/14/2021	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Chief Financial Officer	Chief Financial Officer	Mr.	Aubrey	Rob		1-832-540-2074					Rob.Aubrey@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	03/07/2022	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	CMS Casework Communication Contact	Director, Grievance and Appeals	Mr	Maccioli	James		1-520-874-3247				1-520-874-7083	James.Maccioli2@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	12/20/2021	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Coordination of Benefits Contact	Director Reimbursement Services		Groves	Lori		1-602-469-2249					Lori.Groves@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/30/2021	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Customer Service Operations Contact	Customer Care Director	Mrs	Carrillo	Veronica		1-520-874-5349				1-520-874-7083	Veronica.Carrillo@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	02/14/2021	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Government Relations Contact	Government Programs Sr. Director	Mr.	Thomsen	Ryan		1-520-780-8310					ryan.thomsen@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	04/19/2022	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Hospice Contact	Pharmacy Director	Mr	Pokorney	Tim		1-602-747-2101					Timothy.Pokorney@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	09/27/2021	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Medicare Compliance Officer	Compliance Senior Director	Ms	Corlette	Kristina		1-602-747-2431					BMAComplianceOfficer@BannerHealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/05/2022	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Part D Exceptions Contact	Express Scripts Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	Express Scripts	5151 Blazer Pkwy	Dublin	OH	43017	12/21/2021	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active	1-800-344-3405	733326			PPO - BBA		C	San Francisco
H7273	Pharmacy Network Management Contact	Express Scripts Network Accountant Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	12/21/2021	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7273	Pharmacy Technical Help Desk Contact	Express Scripts (Director, Customer Services)		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	Express Scripts	13051 N Telecom PKWY STE 150	Temple Terrace	FL	33637	12/16/2022	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active	1-800-903-6215				PPO - BBA		C	San Francisco
H7273	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Aubrey	Rob		1-832-540-2074					Rob.Aubrey@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	03/07/2022	2023	BANNER HEALTH INSURANCE GROUP	Local CCP	Banner Medicare Advantage Plus	Local PPO		Banner Health	389	Yes	Active					PPO - BBA		C	San Francisco
H7284	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H7284	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H7284	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7301	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-888-736-9118				1-888-554-7668	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	12/03/2018	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/15/2020	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-602-618-3945				PPO - BBA		C	Philadelphia
H7301	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7301	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-800-238-6279				PPO - BBA		C	Philadelphia
H7301	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H7323	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H7323	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7323	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H7323	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H7326	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/08/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7326	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H7326	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7330	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/11/2019	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Best Available Evidence Contact	COO	Mr.	Collins	GARFIELD		1-312-319-5468				1-312-319-5468	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Chief Financial Officer	CFO	Mr.	Sahin	Mete		1-703-282-5955					mete.sahin@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	CMS Casework Communication Contact	CMO	Dr.	Haywood	Trent		1-312-203-0642					trent.haywood@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Coordination of Benefits Contact	COO	Mr.	Collins	GARFIELD		1-312-319-5468				1-312-319-5468	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Customer Service Operations Contact	V.P. Customer Service	Ms.	Coyle	Gina		1-312-809-8079	183			1-312-809-8079	gina.coyle@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Government Relations Contact	Communication	Mr..	Martin	Stephen		1-312-205-7948	138				stephen.martin@myzing.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Hospice Contact	CMO	Dr.	Haywood	Trent		1-312-203-0642					trent.haywood@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Matuszak	Russell		1-312-832-6676	292			1-312-832-6676	russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Part D Exceptions Contact	Pharmacy Project Manager		Santaya	Carlos							carlos.santaya@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	01/01/2023	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	1-312-477-0778				HMO - Health Maintenance Organization		C	Chicago
H7330	Pharmacy Network Management Contact	Director Pharmacy Network Development and Operatio		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	01/01/2023	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7330	Pharmacy Technical Help Desk Contact	V.P. Operations		Conn	Todd							tconn@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	01/01/2023	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	1-855-476-6993				HMO - Health Maintenance Organization		C	Chicago
H7330	Plan to Plan Reconciliation Contact	CFO	Mr.	Sahin	Mete		1-703-282-5955					mete.sahin@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	08/23/2022	2023	ZING HEALTH, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7360	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/02/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H7360	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7360	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H7360	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare by Health Net	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7366	Automated TrOOP Balance Transfer Contact	Director of Finance		Cordeau	Bryan		1-202-603-9602					bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	Best Available Evidence Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	Chief Financial Officer		Mr	Cordeau	Bryan		1-202-603-9602					Bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	CMS Casework Communication Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	Coordination of Benefits Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	Customer Service Operations Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	Government Relations Contact		Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		los Angles	CA	90018	07/25/2022	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	Medicare Compliance Officer		Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		los Angles	CA	90018	07/25/2022	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	Part D Exceptions Contact	Director of Finance		Cordeau	Bryan							bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active	1-202-603-9602				PACE - Nat		C	San Francisco
H7366	Pharmacy Network Management Contact	Executive Director	Mr	Murphy	Grady		1-213-328-9666					grady.murphy@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7366	Pharmacy Technical Help Desk Contact	Director of Finance		Cordeau	Bryan							bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active	1-202-603-9602				PACE - Nat		C	San Francisco
H7366	Plan to Plan Reconciliation Contact	Director of Finance		Cordeau	Bryan		1-202-603-9602					bryan.cordeau@concertocare.com	3670 Degnan Blvd		Los Angeles	CA	90018	06/02/2021	2023	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	ConcertoHealth PACE of Los Angeles	National PACE		Perfect Health, Inc.	779	Yes	Active					PACE - Nat		C	San Francisco
H7379	Automated TrOOP Balance Transfer Contact	VP, Medicaid/Medicare	Ms.	Billman	Julie		1-410-998-7534					JulieBillman@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	12/09/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Best Available Evidence Contact	VP Medicare		Billman	Julie		1-410-998-7534					julie.billman@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	02/08/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Chief Financial Officer	Interim CFO/Dir, Financial Plng & Analysis	Mr.	Crippen	Ryan		1-410-998-5459					Ryan.Crippen@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2022	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	CMS Casework Communication Contact	VP, Medicare		Billman	Julie		1-410-998-7534					Julie.Billman@Carefirst.com	10455 Mill Run Circle Mailstop	OWML1 18192	Owings Mills	MD	21117	12/09/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Coordination of Benefits Contact	VP Medicare		Billman	Julie		1-410-998-7534					julie.billman@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	02/08/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Customer Service Operations Contact	VP Medicare		Billman	Julie		1-410-998-7534					julie.billman@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	02/08/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Government Relations Contact	Medicare Compliance Officer		Snapp-Borleis	Mary-Paul		1-410-605-2579					mary-paul.snapp-borleis@carefirst.com	1501 S. Clinton Street	7th Floor	Baltimore	MD	21224	12/09/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Hospice Contact	Sr. Dir., Pharm Eval & Oversight		Poplawski	Mandi		1-410-528-5053					Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	12/09/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		1-410-605-2579					Mary-Paul.Snapp-Borleis@Carefirst.com	1501 S Clinton St		Baltimore	MD	21224	02/16/2022	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Part D Exceptions Contact	Sr. Dir., Pharm Eval & Oversight		Poplawski	Mandi							Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	04/28/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active	1-410-528-5053				PPO - BBA		C	Philadelphia
H7379	Pharmacy Network Management Contact	Director Pharmacy Government Programs		Nardone	Mark		1-410-998-5675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	02/08/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7379	Pharmacy Technical Help Desk Contact	Director Pharmacy Government Programs		Nardone	Mark							Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	02/08/2021	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active	1-866-693-4620				PPO - BBA		C	Philadelphia
H7379	Plan to Plan Reconciliation Contact	Interim CFO/Dir, Financial Plng & Analysis	Mr.	Crippen	Ryan		1-410-998-5459					Ryan.Crippen@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2022	2023	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Philadelphia
H7389	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	08/30/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	08/30/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	02/16/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''''''''''''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''''''''''''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H7389	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	02/16/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H7389	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7399	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H7399	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7399	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H7399	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY ILLINOIS	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7404	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/08/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H7404	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7404	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H7404	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H7419	Automated TrOOP Balance Transfer Contact	Senior Manager, Operations	Mr.	Mahoney	Thomas		1-781-612-1000	84897				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Best Available Evidence Contact	Manager, Member Experience	Ms.	Stoesser	Dorothy		1-781-612-1000	82751				dorothy.stoesser@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Chief Financial Officer	SVP Chief Financial Officer	Mr.	Kurpad	Umesh		1-781-612-1000	84968				umesh.kurpad@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	CMS Casework Communication Contact	Director, Appeals & Grievances	Ms.	Evans	Kathleen		1-617-972-9400	87204				kathleen.evans@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Coordination of Benefits Contact	Vice President, Claims	Mr.	Fernandez	David		1-617-584-4884					david.fernandez@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Customer Service Operations Contact	Manager, Member Experience	Ms.	Stoesser	Dorothy		1-781-612-1000	82751				dorothy.stoesser@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Government Relations Contact	Chief Government Affairs Officer	Ms.	Lewis	Kristin		1-781-612-1000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Hospice Contact	Manager, Pharmacy Operations & Programs	Ms.	MacAuley	Jacqueline		1-781-612-1000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Medicare Compliance Officer	Medicaid Compliance Officer	Mr.	Camper	Stephen		1-781-612-1000	84759				stephen.camper@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-781-612-1000	82370			Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Pharmacy Network Management Contact	Manager, Retail Network Operations		Hagan	Kyle		1-303-989-5828					Kyle.hagan@optum.com	7120 W Iowa Ave		lakewood	CO	80232	12/08/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Summers	Todd							todd.summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173-6801	12/08/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-855-524-0380				Demo Risk Option C	MMP HMO Demo	C	Boston
H7419	Plan to Plan Reconciliation Contact	Manager, Finance Operations	Ms.	Olson	Rachel		1-781-612-1000	84360				rachel.olson@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS HEALTH PUBLIC PLANS, INC.	Demo	Tufts Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H7445	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Chief Financial Officer		Mr.	Berquist	Blake		1-952-931-5735					blake_d_berquist@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/20/2022	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H7445	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7445	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/01/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H7445	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/04/2020	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H7464	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7464	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H7464	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7469	Automated TrOOP Balance Transfer Contact	VP of Finance		Dohn	Charles		1-904-407-6424					charles.dohn@aliviacare.com	4266 Sunbeam Rd		Jacksonville	FL	32257	07/19/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	Best Available Evidence Contact	Program Director	Mrs.	Bretz	Amy		1-904-490-9147					abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	Chief Financial Officer		Mr.	Ward	Phillip		1-904-407-6480					pward@communityhospice.com	4266 Sunbeam Road		Jacksonville	FL	32257	03/28/2017	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	CMS Casework Communication Contact	Program Director	Mrs.	Bretz	Amy		1-904-490-9147					abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	Coordination of Benefits Contact	Program Director	Mrs.	Bretz	Amy		1-904-490-9147					abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	Customer Service Operations Contact	Program Director	Mrs.	Bretz	Amy		1-904-490-9147					abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	Government Relations Contact	Program Director	Mrs.	Bretz	Amy		1-904-490-9147					abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	Medicare Compliance Officer	QI Manager	Mr.	Stevenson	Kenny		1-904-407-5033					Kenny.Stevenson@aliviacare.com	4266 Sunbeam Road		Jacksonville	FL	32257	07/29/2021	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	Part D Exceptions Contact	Program Director	Mrs.	Bretz	Amy	D						abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active	1-904-490-9147				PACE - Nat		C	Atlanta
H7469	Pharmacy Network Management Contact	Program Director	Mrs.	Bretz	Amy		1-904-490-9147					abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7469	Pharmacy Technical Help Desk Contact	Program Director	Mrs.	Bretz	Amy							abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active	1-904-490-9147				PACE - Nat		C	Atlanta
H7469	Plan to Plan Reconciliation Contact	Program Director	Mrs.	Bretz	Amy		1-904-490-9147					abretz@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	02/01/2022	2023	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active					PACE - Nat		C	Atlanta
H7501	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		1-858-790-6250				1-858-790-6052	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Best Available Evidence Contact	Director of PACE	Ms.	Macias	Monica		1-714-468-1077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	04/16/2021	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Chief Financial Officer	Chief Financial Officer	Ms.	Huang	Nancy		1-657-235-6935					nhuang@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	CMS Casework Communication Contact	Director, Clinical Pharmacy Management	Ms.	Gericke	Kristin		1-714-246-8471					kgericke@caloptima.org	505 City Parkway West		Orange	CA	92868	12/24/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Coordination of Benefits Contact			Cardenas	Albert		1-714-246-8878					COBinquiries@caloptima.org	505 City Parkway West		Orange	CA	92868	04/21/2022	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Customer Service Operations Contact	Director of PACE	Ms.	Macias	Monica		1-714-468-1077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	04/16/2021	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Government Relations Contact	Manager	Ms.	Gomez	Gisela		1-714-246-8757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Medicare Compliance Officer	Director of Regulatory Affairs and Compliance	Ms.	Phillips	Annie		1-657-235-6994					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	07/21/2022	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Part D Exceptions Contact	Director, Clinical Pharmacy Management	Ms.	Gericke	Kristin							kgericke@caloptima.org	505 City Parkway West		Orange	CA	92868	12/24/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active	1-888-587-8088				PACE - Nat		C	San Francisco
H7501	Pharmacy Network Management Contact	Manager, PNS & Claims Operations		Burke	Sharon		1-858-790-7148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/24/2019	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active	1-800-810-0554				PACE - Nat		C	San Francisco
H7501	Plan to Plan Reconciliation Contact	Controller	Mr.	Kaing	Jason		1-657-900-1373					p2p@caloptima.org	505 City Parkway West		Orange	CA	92868	04/30/2020	2023	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7511	Automated TrOOP Balance Transfer Contact	Senior Director of Government Programs	Ms.	Fuller	Rebecca		1-605-328-7007					rebecca.fuller@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Best Available Evidence Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Chief Financial Officer	Vice President of Finance	Mr.	Maude	Brian		1-605-328-6801					Brian.Maude@SanfordHealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	CMS Casework Communication Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		1-605-328-7182					aleesa.jansick@sanfordhealth.org	300 Cherapa place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Coordination of Benefits Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Customer Service Operations Contact	Director of Customer Service	Mr.	Ling	Ryan		1-605-312-7459					ryan.ling@sanfordhealth.org	300 N Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Government Relations Contact	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Hospice Contact	Director of Utilization Management	Ms.	Kanta	Misty		1-605-312-2788					misty.kanta@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Part D Exceptions Contact	Manager, Prior Authorization	Ms.	Le	Christina						1-877-239-4565	rxsol_prior_auth_redirected_queue_DL@uhc.com	3515 Harbor Blvd		Costa Mesa	CA	92626	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	1-888-403-3398				HMO - Health Maintenance Organization		C	Dallas
H7511	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7511	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway	Suite 200	Schaumburg	IL	60173-6801	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	1-844-642-9090				HMO - Health Maintenance Organization		C	Dallas
H7511	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		1-605-312-9344					debora.harris@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7512	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/02/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H7512	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7512	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H7512	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H7518	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7518	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H7518	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7522	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Best Available Evidence Contact	AVP Enrollment and Membership Accounting	Ms.	Suarez	Yamile		1-787-622-3000	1745			1-787-999-2199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918-2137	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Chief Financial Officer	Chief Financial Officer	Mr.	Vivaldi	Carlos		1-787-622-3000	2295			1-787-622-0471	Carlos.Vivaldi@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	CMS Casework Communication Contact	Compliance Operations AVP	Ms.	Hiraldo	Marieva		1-787-622-3000	2259			1-787-622-0471	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Coordination of Benefits Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Customer Service Operations Contact	Vice President of Operations	Mr.	Cruz	Christian		1-787-908-0779					christian.cruz@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00936	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Government Relations Contact	Corporate Compliance Officer	Ms.	Plumey	Myra		1-787-379-3327				1-787-622-0471	myra.plumey@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Hospice Contact	Pharmacy Operations Support and Quality Assurance	Mr	Mercado Toro	Jose		1-787-622-3000	58679			1-787-300-5503	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Medicare Compliance Officer	Corporate Compliance Officer	Ms.	Plumey	Myra		1-787-379-3327				1-787-622-0471	myra.plumey@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	12/10/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Exceptions Contact	Pharmacy Operation Director	Ms	Rivera	Erika						1-787-300-5503	erika.rivera@mmmhc.com	PO BOX 71114		San Juan	PR	00936-8014	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-866-333-5470	8633			PPO - BBA		C	Chicago
H7522	Pharmacy Network Management Contact	Pharmacy Services Manager	Ms	Rodriguez	Isis		1-787-653-2814				1-787-286-6032	irodriguezp@mc-21.com	MC-21 Corporation	Call Box 4908	Caguas	PR	00726	11/11/2016	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Pharmacy Technical Help Desk Contact	PharmacyAVP		Caratini	Fernando						1-787-300-5503	Fernando.Caratini-Gregorio@mmmhc.com	PO BOX 71114		San Juan	PR	00936-8014	12/27/2022	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-877-776-7706				PPO - BBA		C	Chicago
H7522	Plan to Plan Reconciliation Contact	Revenue and Med Cost Accounting Supervisor	Mr.	Serrano Figueroa	Juan		1-787-622-3000	2112				Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	08/17/2021	2023	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7524	Automated TrOOP Balance Transfer Contact	Medicare Product Operations Specialist		Laird	Jennifer		1-585-339-7717					Jennifer.Laird@excellus.com	165 Court Street		Rochester	NY	14647	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Best Available Evidence Contact	Supervisor Medicare Operations		Piershalski	Dana		1-716-857-4435					Dana.Piershalski@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Chief Financial Officer	Executive Vice President & Chief Financial Officer	Mr.	Gorecki	Christophe	M	1-480-993-5254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	CMS Casework Communication Contact	Medicare Compliance Program Administrator		Gomez	Rafael		1-716-857-6226					Rafael.Gomez@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Coordination of Benefits Contact	Manager, Enrollment Operations		Webster	Kimberly		1-585-472-1851					Kimberly.Webster@excellus.com	165 Court Street		Rochester	NY	14647	04/26/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Customer Service Operations Contact	Vice President, Customer Care		Levi	Alexander		1-585-399-6683					Alexander.Levi@excellus.com	300 Main St.		E. Rochester	NY	14445	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Government Relations Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		1-585-339-7745					Laura.Dibble@excellus.com	165 Court Street		Rochester	NY	14647	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Hospice Contact	Manager, Pharmacy Utilization Management		Khan	Joe		1-716-843-7881					Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dibble	Laura		1-585-339-7745					Laura.Dibble@excellus.com	165 Court Street		Rochester	NY	14647	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Part D Exceptions Contact	Manager, Pharmacy Utilization Management		Khan	Joe							Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	1-716-843-7881				HMO - Health Maintenance Organization		C	New York
H7524	Pharmacy Network Management Contact	Pharmacy Operations Support		Brown	Burt		1-585-327-7530				1-585-339-6640	Burt.Brown@excellus.com	165 Court Street		Rochester	NY	14647	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7524	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy	Ste 150	Temple Terrace	FL	33637	01/17/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H7524	Plan to Plan Reconciliation Contact	Manager, Finance Operations		Simmons	Jennifer		1-585-231-6874					Jennifer.Simmons@excellus.com	165 Court Street		Rochester	NY	14647	12/08/2022	2023	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7556	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/05/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H7556	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7556	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H7556	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/05/2021	2023	CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC.	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H7557	Automated TrOOP Balance Transfer Contact			Rush	Jamie		1-561-690-1134					ESITroopTransfer@express-scripts.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Best Available Evidence Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N 107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Chief Financial Officer		Mr.	Granow	Les		1-561-444-0709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	CMS Casework Communication Contact			Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Coordination of Benefits Contact		Ms.	Burdelik	Dawn		1-561-815-3729					dawn.burdelik@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Customer Service Operations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Government Relations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Hospice Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Medicare Compliance Officer		Ms.	Lacey	Jennifer		1-813-367-7169					Jennifer.lacey@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						1-888-235-8551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-204-0016				HMO - Health Maintenance Organization		C	New York
H7557	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		1-800-204-0016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7557	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						1-888-235-8551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H7557	Plan to Plan Reconciliation Contact		Ms.	Zhai	Vicky		1-561-632-8915					Vicky.Zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/14/2021	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H7559	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7559	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H7559	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	Molina Healthcare of Virginia, LLC	Local CCP	Molina Healthcare of Virginia	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7598	Automated TrOOP Balance Transfer Contact	Clinical Pharmacy Manager		Hofer	Alissa		1-715-852-2096					ahofer@pharmastar.com	2411 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Best Available Evidence Contact	Chief Financial Officer	Mr.	Tanner	Robert		1-715-852-2064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Chief Financial Officer	Chief Financial Officer	Mr.	Tanner	Robert		1-715-852-2064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	CMS Casework Communication Contact	Chief Medical Officer		Bauer	Michele		1-715-852-5721					mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Coordination of Benefits Contact	Service Manager		Spurlock	Dual		1-715-852-2618					dspurlock@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/20/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Customer Service Operations Contact	Service Manager		Spurlock	Dual		1-715-852-2618				1-715-836-7683	dspurlock@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/20/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Government Relations Contact	CEO and General Manager		North	Sarah		1-715-852-2090					snorth@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Hospice Contact	Chief Medical Officer		Bauer	Michele		1-715-852-5721					mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Medicare Compliance Officer	Executive Director of Compliance	Mrs.	McCracken	Sarah		1-715-852-5725					smccracken@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/20/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Part D Exceptions Contact	Chief Medical Officer		Bauer	Michele							mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active	1-888-203-7770				HMO - Health Maintenance Organization		C	Chicago
H7598	Pharmacy Network Management Contact	Clinical Pharmacy Manager	Ms.	Hofer	Alissa		1-715-852-2096					ahofer@pharmastar.com	2411 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7598	Pharmacy Technical Help Desk Contact	Service Manager		Spurlock	Dual						1-715-852-2618	dspurlock@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/20/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active	1-888-203-7770				HMO - Health Maintenance Organization		C	Chicago
H7598	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Tanner	Robert		1-715-852-2064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2023	GROUP HEALTH COOPERATIVE OF EAU CLAIRE	Local CCP	Group Health Cooperative of Eau Claire	HMO/HMOPOS		Group Health Cooperative of Eau Claire	754	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7605	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H7605	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7605	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H7605	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7607	Automated TrOOP Balance Transfer Contact		Mr.	Zlotkus	Steve		1-858-790-6250					Steve.Zlotkus@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/11/2020	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Best Available Evidence Contact	SVP of Operations	Mrs.	Ramsey	Erin	R	1-714-650-8742					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	08/12/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Chief Financial Officer	CFO	Mr.	Pham	Hiep	D	1-714-422-5089					Hiep.Pham@clevercarehealthplan.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	03/29/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	CMS Casework Communication Contact	SVP of Operations	Mrs.	Ramsey	Erin	R	1-714-650-8742					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	08/12/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Coordination of Benefits Contact	SVP of Operations	Mrs.	Ramsey	Erin	R	1-714-650-8742					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	07/27/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Customer Service Operations Contact	Manager, A&G	Ms.	Sprague	Ashlee		1-714-650-8768					ashlee.sprague@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	04/18/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Government Relations Contact	COO	Mr.	Lee	Myong	S	1-917-923-9858					myong.lee@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	04/18/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Hospice Contact	SVP of Operations	Mrs.	Ramsey	Erin	R	1-714-650-8742					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	07/27/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Medicare Compliance Officer	VP, Audit & Compliance Officer	Mrs.	Coleman	Sabrina		1-626-514-9140					sabrina.coleman@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	10/14/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Part D Exceptions Contact			Martin	Dawn							AppealGrievancesManagement@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/03/2020	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active	1-858-790-7118				HMO - Health Maintenance Organization		C	San Francisco
H7607	Pharmacy Network Management Contact			Burke	Sharon	S	1-858-790-7148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/11/2020	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7607	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services.		Brewer	Kathy							CustomerService@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/15/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active	1-800-926-3004				HMO - Health Maintenance Organization		C	San Francisco
H7607	Plan to Plan Reconciliation Contact	CFO	Mr.	Pham	Hiep	D	1-714-422-5089					Hiep.Pham@clevercarehealthplan.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	04/18/2022	2023	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7617	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H7617	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H7617	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7619	Automated TrOOP Balance Transfer Contact	Executive Director	Mr.	DiBiase	Michael		1-609-572-8588					michael.dibiase@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	05/29/2020	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Best Available Evidence Contact	Executive Director	Mr.	DiBiase	Michael		1-609-572-8588					michael.dibiase@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	05/29/2020	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Chief Financial Officer	CFO	Mr.	Kim	Hak		1-609-569-7031					hak.kim@atlanticare.org	2500 English Creek Avenue	Building 500	Egg Harbor Township	NJ	08234	08/16/2021	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	CMS Casework Communication Contact	Medical Director	Dr.	Mazur	Kimberly		1-609-572-8588					Kimberly.Mazur@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	01/03/2023	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Coordination of Benefits Contact	Medical Director	Dr.	Mazur	Kimberly		1-609-572-8588					Kimberly.Mazur@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	01/03/2023	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Customer Service Operations Contact	Quality Assurance Director	Ms.	Williams	Erin		1-609-572-8588					erin.williams@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	11/21/2018	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Government Relations Contact	Executive Director	Mr.	DiBiase	Michael		1-609-572-8588					michael.dibiase@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	04/09/2019	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Medicare Compliance Officer	Quality Assurance Director	Ms.	Williams	Erin		1-609-572-8588					erin.williams@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	11/21/2018	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Part D Exceptions Contact	Medical Director	Dr.	Mazur	Kimberly							Kimberly.Mazur@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	01/03/2023	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active	1-609-572-8588				PACE - Nat		C	New York
H7619	Pharmacy Network Management Contact	Medical Director	Dr.	Mazur	Kimberly		1-609-572-8588					Kimberly.Mazur@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	01/03/2023	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Mazur	Kimberly							Kimberly.Mazur@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	01/03/2023	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active	1-609-572-8588				PACE - Nat		C	New York
H7619	Plan to Plan Reconciliation Contact	Medical Director	Dr.	Mazur	Kimberly		1-609-572-8588					Kimberly.Mazur@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	01/03/2023	2023	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7621	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H7621	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7621	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H7621	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7646	Automated TrOOP Balance Transfer Contact	Dir., Engagement Delivery	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/14/2021	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Best Available Evidence Contact	Director, Engagement Delivery	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/14/2021	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Chief Financial Officer	CFO	Mr.	Vozzo	Edward		1-406-465-2409					Edward.Vozzo@PHPMM.org	1400 E. Michigan Ave.		Lansing	MI	48912-2107	05/02/2022	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	CMS Casework Communication Contact	Director, Medicare Compliance	Ms.	Coberly	Michelle		1-269-352-9564					michelle.coberly@phpmm.org	1400 E. Michigan Ave.		Lansing	MI	48912-2107	04/01/2022	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Coordination of Benefits Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					COBInquiry@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/27/2022	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoeffer	Linda		1-636-686-9682					rmeyerhoeffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/08/2021	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Government Relations Contact	Director, Medicare Compliance	Ms.	Coberly	Michelle		1-269-352-9564					michelle.coberly@phpmm.org	1400 E. Michigan Ave.		Lansing	MI	48912-2107	12/01/2022	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Hospice Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/04/2019	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Medicare Compliance Officer	Director Medicare Compliance	Ms.	Coberly	Michelle		1-269-352-9564					michelle.coberly@phpmm.org	1400 E. Michigan Ave.		Lansing	MI	48912-2107	12/27/2019	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian							brian_schumm@express-scripts.com	5151 Blazer Parkway		Dublin	OH	43017	04/01/2022	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active	1-800-334-3405	73326			HMO - Health Maintenance Organization		C	Chicago
H7646	Pharmacy Network Management Contact	Network Account Director	Ms.	Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		Saint Louis	MO	63121	12/12/2019	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7646	Pharmacy Technical Help Desk Contact	Director Customer Service	Ms.	Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy Suite 150		Temple Terrace	FL	33637	11/18/2021	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H7646	Plan to Plan Reconciliation Contact	Manager, Client Payments	Ms.	Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/19/2021	2023	PHP MEDICARE	Local CCP	PHP Medicare	HMO/HMOPOS		Sparrow Health System	727	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7656	Automated TrOOP Balance Transfer Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	06/01/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	Best Available Evidence Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	06/01/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	Chief Financial Officer	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	06/01/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	CMS Casework Communication Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/15/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	Coordination of Benefits Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	06/01/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	Customer Service Operations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/15/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	Government Relations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/15/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	Medicare Compliance Officer	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/15/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	Part D Exceptions Contact	CFO		Prentis	Kristin							kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	06/01/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending	1-732-806-3224				PACE - Nat		C	San Francisco
H7656	Pharmacy Network Management Contact	Executive Director	Mrs	Runyon	Bobbi		1-732-592-3400					brunyon@beaconpace.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	09/15/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7656	Pharmacy Technical Help Desk Contact	Executive Director	Mrs	Runyon	Bobbi							brunyon@beaconpace.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	09/15/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending	1-732-592-3400				PACE - Nat		C	San Francisco
H7656	Plan to Plan Reconciliation Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	06/01/2022	2023	VALLEY PACE, LLC	National PACE	Valley PACE, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H7660	Automated TrOOP Balance Transfer Contact	Director Financial Management	Mr.	Hamm	David		1-724-776-1100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/23/2022	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Best Available Evidence Contact	Director Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Chief Financial Officer	CFO	Mr.	Carraway	Jeffrey		1-724-776-1100					jeffrey.carraway@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	02/02/2018	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	CMS Casework Communication Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Coordination of Benefits Contact	Director Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Customer Service Operations Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Government Relations Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Medicare Compliance Officer	Director Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/21/2017	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Part D Exceptions Contact	Director Financial Management	Mr.	Hamm	David							dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/16/2016	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active	1-724-742-2226				PACE - Nat		C	Philadelphia
H7660	Pharmacy Network Management Contact	Executive Director	Ms	Kisow	Leslie		1-724-776-1100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Hanna	Abeer							abeer.hanna@lutheranseniorlife.org	LIFE-Beaver County Center Place	131 Pleasant Drive Suite 1	Aliquippa	PA	15001	10/03/2022	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active	1-724-378-5400				PACE - Nat		C	Philadelphia
H7660	Plan to Plan Reconciliation Contact	Director Financial Management	Mr.	Hamm	David		1-724-742-2226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2023	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7670	Automated TrOOP Balance Transfer Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Best Available Evidence Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Chief Financial Officer	CFO	Mr.	Beerman	James		1-774-701-1437					james.beermann@massadvantage.com	365 Plantation St	3rd Floor	Worcester	MA	01605	01/10/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	CMS Casework Communication Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Coordination of Benefits Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Customer Service Operations Contact	Vice President		Velten	Steve		1-816-435-7408					svelten@dsthealth.com	210 W 10th St		Kansas	MO	64105	06/08/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Government Relations Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Hospice Contact	Vice President		Velten	Steve		1-816-435-7408					svelten@dsthealth.com	210 W 10th St		Kansas	MO	64105	06/08/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Part D Exceptions Contact	Vice President, Compliance & Contracting		Cone	Mark							mark.cone@sscinc.com	210 W. 10th Street		Kansas City	MO	64105	04/09/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active	1-816-843-6461				HMO - Health Maintenance Organization		C	New York
H7670	Pharmacy Network Management Contact	Sr Director Pharmacy Network Analytics and Pricing		Huffman	Gregg		1-816-435-2471					ghuffman@sscinc.com	210 W 10th St		Kansas City	MO	64105	10/18/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7670	Pharmacy Technical Help Desk Contact	Sr Director Pharmacy Network Analytics and Pricing		Huffman	Greg							ghuffman@sscinc.com	210 W 10th St		Kansas City	MO	64105	10/24/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active	1-844-918-0114				HMO - Health Maintenance Organization		C	New York
H7670	Plan to Plan Reconciliation Contact	Vice President, Compliance & Contracting		Cone	Mark		1-816-843-6461					mark.cone@sscinc.com	210 W. 10th Street		Kansas City	MO	64105	04/09/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H7678	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7678	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H7678	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7680	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Manosca	Nova		1-858-790-5873					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/31/2016	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Best Available Evidence Contact	Chief Operating Officer	Mr.	Koltz	Patrick		1-775-770-9240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	03/08/2022	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Chief Financial Officer	Chief Finance Officer	Mr.	Hsieh	David		1-610-382-4858					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/01/2022	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	CMS Casework Communication Contact	Manager of Compliance & Risk Management	Mrs.	Ballard-Martenies	Kerri	L	1-775-225-3334					kerri.ballard-martenies@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	01/26/2021	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Coordination of Benefits Contact	Chief Operating Officer	Mr.	Koltz	Patrick		1-775-770-9240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	03/08/2022	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Customer Service Operations Contact	Chief Operating Officer		Koltz	Patrick		1-775-770-9240					patrick.koltz@uhsinc.com	1510 Meadow Wood Ln		Reno	NV	89502	03/08/2022	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Government Relations Contact	Chief Compliance Officer	Mr.	Ramirez	Philip		1-775-770-9348					philip.ramirez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	04/16/2020	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Hospice Contact	Health Services Director		Estipona	Steve		1-775-770-9462					Steve.Estipona@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	01/31/2018	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Ramirez	Philip		1-775-770-9348					philip.ramirez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/02/2018	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Part D Exceptions Contact	Manager, QA & Client Services		Nguyen	Quan							Quan.nguyen@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/08/2017	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	1-858-790-7151				HMO - Health Maintenance Organization		C	San Francisco
H7680	Pharmacy Network Management Contact	Director, Configuration Services		Lujan	Jennifer		1-858-790-6565					jennifer.lujan@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/02/2018	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7680	Pharmacy Technical Help Desk Contact	Direct Contact Center Services		Battle	Dorry							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/22/2017	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	1-844-587-7389				HMO - Health Maintenance Organization		C	San Francisco
H7680	Plan to Plan Reconciliation Contact	Manager of Finance	Mr.	Lopez	Robert		1-775-770-9374					Robert.lopez3@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/01/2022	2023	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H7725	Automated TrOOP Balance Transfer Contact	Business Office Manager		Cox	Terra		1-970-508-7737				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	Best Available Evidence Contact	Executive Director	Ms.	Booker	Chiquita		1-502-314-2059					cbooker@voa.org	960 S 4th St.		Louisville	KY	40203	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	Chief Financial Officer	VP of Financial Services	Ms	Gavin	Nancy		1-612-428-7840				1-952-941-0428	ngavin@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	CMS Casework Communication Contact	Executive Director	Ms.	Booker	Chiquita		1-502-314-2059				1-517-319-0650	cbooker@voa.org	960 S 4th St.		Louisville	KY	40203	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	Coordination of Benefits Contact	Executive Director	Ms.	Booker	Chiquita		1-502-314-2059				1-517-319-0650	cbooker@voa.org	960 S 4th St.		Louisville	KY	40203	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	Customer Service Operations Contact	Executive Director	Ms.	Booker	Chiquita		1-502-314-2059				1-517-319-0650	cbooker@voa.org	960 S 4th St.		Louisville	KY	40203	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	Government Relations Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	Medicare Compliance Officer	PACE Director of Program Integrity/Compliance	Ms.	Linnell	Kathryn	R	1-970-508-7757				1-866-829-9949	klinnell@voa.org	2377 Robins Way		Montrose	CO	81401	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	Part D Exceptions Contact	Executive Director	Mr.	Robbins	Ken						1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending	1-517-319-0690				PACE - Nat		C	Chicago
H7725	Pharmacy Network Management Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7725	Pharmacy Technical Help Desk Contact	Executive Director	Mr.	Robbins	Ken						1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending	1-517-319-0690				PACE - Nat		C	Chicago
H7725	Plan to Plan Reconciliation Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H7728	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H7728	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7728	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H7728	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7746	Automated TrOOP Balance Transfer Contact	MIG Vice President Pharmacy		Musial	Brian		1-317-822-7523					bmusial@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	03/02/2022	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Best Available Evidence Contact	Director, Claims and Membership		Laney	Vicki		1-810-733-9724					vicki.laney@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/27/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Chief Financial Officer	VP & Chief Financial Officer	Ms.	Diehl	Cheryl		1-989-992-3272					cheryl.diehl@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/27/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	CMS Casework Communication Contact	Manager, MIG Customer & Provider Operations		Cuccia	Tami		1-810-733-9669					tami.cuccia@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/15/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Coordination of Benefits Contact	Director, Claims and Membership		Laney	Vicki		1-810-733-9724					vicki.laney@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/27/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Customer Service Operations Contact	VP, Health Plan Operations		Everett	Torriaun		1-317-822-7439					teverett@mdwise.org	2955 N Meridian St	Ste 201	Indianapolis	IN	46208	01/27/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Government Relations Contact	VP General Counsel	Ms.	Hebenstreit	Patty		1-317-822-7306					phebenstreit@mdwise.org	2955 N Meridian St	Ste 201	Indianapolis	IN	46208	01/27/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Hospice Contact	Pharmacy Business Analyst		Farley	Lisa		1-317-983-7822					lfarley@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	02/10/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Anderson	Paula		1-765-631-3511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	07/25/2022	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Part D Exceptions Contact	Director of Clinical Pharmacy		Powell	Wendi							wpowell@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	11/11/2022	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	1-800-356-1204				HMO - Health Maintenance Organization		C	Chicago
H7746	Pharmacy Network Management Contact	Pharmacy Business Analyst		Farley	Lisa		1-317-983-7822					lfarley@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	02/10/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7746	Pharmacy Technical Help Desk Contact	VP Contact Center Services		Battle	Dorry							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/29/2021	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	1-800-910-4691				HMO - Health Maintenance Organization		C	Chicago
H7746	Plan to Plan Reconciliation Contact	Finance Director		de los Reyes	Jamie		1-810-733-9657					jamie.delosreyes@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	04/19/2022	2023	MDWISE, INC	Local CCP	MDwise Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	Chicago
H7778	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7778	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	Chicago
H7778	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	02/03/2022	2023	UNITEDHEALTHCARE OF ILLINOIS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7779	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/18/2020	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H7779	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7779	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-833-502-6757				HMO - Health Maintenance Organization		C	Dallas
H7779	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7787	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''''''''''''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''''''''''''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active	1-480-548-0643				PPO - BBA		C	New York
H7787	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7787	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active	1-800-922-1557				PPO - BBA		C	New York
H7787	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7813	Automated TrOOP Balance Transfer Contact	Consulting Pharmacist		SokalDavidson	Anita		1-315-593-9953					Anita.SokalDavidson@cdsrx.org	860 Hard Rd		Webster	NY	14580	09/02/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Best Available Evidence Contact	Consulting Pharmacist		SokalDavidson	Anita		1-315-593-9953					Anita.SokalDavidson@cdsrx.org	860 Hard Rd		Webster	NY	14580	09/02/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Chief Financial Officer	Corporate CFO	Mr	Ferrari	Richard		1-585-347-1209					richard.ferrari@cdslt.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	CMS Casework Communication Contact	COO		Marble	Sharon		1-585-347-1215					sharon.marble@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Coordination of Benefits Contact	COO		Marble	Sharon		1-585-347-1215					sharon.marble@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Customer Service Operations Contact	Manager of Enrollment & Member Services		Ortiz	Becky		1-585-347-1923					becky.ortiz@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Government Relations Contact	EVP of Government Relations and Corporate Planning		Valk	Andrea		1-585-313-6427					andrea.valk@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Hospice Contact	COO		Marble	Sharon		1-585-347-1215					sharon.marble@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Medicare Compliance Officer	VP of Quality & Compliance	Ms.	Frederico	Diane		1-585-347-1924					diane.frederico@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Part D Exceptions Contact	Consulting Pharmacist		SokalDavidson	Anita							ryanthomas@icirclecny.org	860 Hard Rd		Webster	NY	14580	09/02/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active	1-833-682-1192				HMO - Health Maintenance Organization		C	New York
H7813	Pharmacy Network Management Contact	Director Pharmacy Network Development & Operations		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	05/31/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7813	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							tconn@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active	1-833-682-1192				HMO - Health Maintenance Organization		C	New York
H7813	Plan to Plan Reconciliation Contact	Manager of Enrollment & Member Services		Ortiz	Becky		1-585-347-1923					becky.ortiz@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2023	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7831	Automated TrOOP Balance Transfer Contact	CEO		Dickens	Elizabeth	D	1-314-897-7223	30002				ddickens@newhorizonspace.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	08/19/2022	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Best Available Evidence Contact	Executive Director		Dickens	Denise		1-314-897-7223	30002				ddickens@newhorizonsliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	11/29/2021	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Chief Financial Officer	Contoller	Ms.	Hudson	Kenna		1-314-587-7900					khudson@chliving.org	Two City Place 2nd Floor		Saint Louis	MO	63141	08/19/2022	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	CMS Casework Communication Contact	Executive Director		Dickens	Denise		1-314-897-7223					ddickens@newhorizonsliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	11/29/2021	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Coordination of Benefits Contact	CEO		Dickens	Elizabeth	D	1-314-897-7223	30002				amiller@chliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	08/19/2022	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Customer Service Operations Contact	Executive Director		Dickens	Denise		1-314-897-7223	30002				ddickens@newhorizonsliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	11/29/2021	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Government Relations Contact	Executive Director		Dickens	Denise		1-314-897-7223					ddickens@newhorizonsliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	11/29/2021	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Medicare Compliance Officer	Director of Center Services	Ms.	Young	Cynthia		1-314-897-7223					cyoung@chliving.org	5035 Manchester Ave		Saint Louis	MO	63110	05/31/2022	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part D Exceptions Contact	Executive Director		Dickens	Denise							ddickens@newhorizonsliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	11/29/2021	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active	1-833-654-7223				PACE - Nat		C	Kansas City
H7831	Pharmacy Network Management Contact	Executive Director		Dickens	Denise		1-314-897-7223					ddickens@newhorizonsliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	11/29/2021	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Pharmacy Technical Help Desk Contact	Executive Director		Dickens	Denise							ddickens@newhorizonsliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	11/29/2021	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active	1-833-654-7223				PACE - Nat		C	Kansas City
H7831	Plan to Plan Reconciliation Contact	Executive Director		Dickens	Denise		1-314-897-7223					ddickens@newhorizonsliving.org	5035 MANCHESTER AVE		ST LOUIS	MO	63110	11/29/2021	2023	PRIME ACQUISITIONS, LLC	National PACE	New Horizons PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7833	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/04/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	01/21/2022	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Demo Risk Option C	MMP HMO Demo	C	Dallas
H7833	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H7844	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Government Relations Contact	MHM- Associate Vice President, Government Contract		Crandell	Peggy		1-947-218-0965					peggy.crandell@molinahealthcare.com	880 E.Long Lake Rd		Troy	MI	48098	07/06/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				Demo Risk Option C	MMP HMO Demo	C	Chicago
H7844	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF MICHIGAN, INC.	Demo	Molina Healthcare of Michigan	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H7849	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O''''''''''''''''''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O''''''''''''''''''''''''''''''''Donnell Street		Baltimore	MD	21224	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active	1-480-548-0643				PPO - BBA		C	New York
H7849	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7849	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active	1-800-922-1557				PPO - BBA		C	New York
H7849	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Cigna	Local PPO		CIGNA	38	Yes	Active					PPO - BBA		C	New York
H7855	Automated TrOOP Balance Transfer Contact	Health Plan Specialist	Ms.	Boothe	Janice		1-818-774-3033				1-818-774-5907	janice.boothe@jha.org	7150 Tampa Avenue		Reseda	CA	91335	10/04/2021	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	Best Available Evidence Contact	Health Plan Specialist	Ms.	Boothe	Janice		1-818-774-3033				1-818-774-5907	janice.boothe@jha.org	7150 Tampa Avenue		Reseda	CA	91335	01/07/2016	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	Chief Financial Officer	Chief Financial Officer	Ms	Ruditsky	Crystal		1-818-774-3336				1-818-774-3020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/03/2022	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	CMS Casework Communication Contact	Executive Director	Ms.	Fishenfeld	Susie		1-818-774-3274				1-818-774-5907	susie.fishenfeld@jha.org	7150 Tampa Avenue		Reseda	CA	91335	01/07/2016	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	Coordination of Benefits Contact	Health Plan Specialist	Ms.	Boothe	Janice		1-818-774-3033				1-818-774-5907	janice.boothe@jha.org	7150 Tampa Avenue		Reseda	CA	91335	10/04/2021	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	Customer Service Operations Contact	Executive Director	Ms.	Fishenfeld	Susie		1-818-774-3274				1-818-774-5907	susie.fishenfeld@jha.org	7150 Tampa Avenue		Reseda	CA	91335	11/08/2017	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	Government Relations Contact	Executive Director	Ms.	Fishenfeld	Susie		1-818-774-3274				1-818-774-5907	susie.fishenfeld@jha.org	7150 Tampa Avenue		Reseda	CA	91335	01/07/2016	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	Medicare Compliance Officer	Compliance Officer	Mr.	Carlson	Timothy		1-818-774-3397				1-818-774-2424	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	04/24/2017	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	Part D Exceptions Contact	Health Plan Specialist	Ms.	Boothe	Janice						1-818-774-5907	janice.boothe@jha.org	7150 Tampa Avenue		Reseda	CA	91335	10/04/2021	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active	1-855-774-8444				PACE - Nat		C	San Francisco
H7855	Pharmacy Network Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		1-818-757-4418				1-818-774-5907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7855	Pharmacy Technical Help Desk Contact	Pharmacist	Ms.	Aramyan	Ani						1-818-774-5900	ani.aramyan@jha.org	7150 Tampa Avenue		Reseda	CA	91335	01/07/2016	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active	1-855-654-3023				PACE - Nat		C	San Francisco
H7855	Plan to Plan Reconciliation Contact	Health Plan Specialist	Ms.	Boothe	Janice		1-818-774-3033				1-818-774-5907	janice.boothe@jha.org	7150 Tampa Avenue		Reseda	CA	91335	10/04/2021	2023	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE		Los Angeles Jewish Home for the Aging	506	Yes	Active					PACE - Nat		C	San Francisco
H7917	Automated TrOOP Balance Transfer Contact	Advisor Business CVS		Davis	Brittany		1-480-606-4613					FIRSupport@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/21/2021	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Best Available Evidence Contact	Manager MedAdv Member & Recon		Mills	Aaron		1-423-535-3848					Aaron_Mills@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/10/2012	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Chief Financial Officer	Exec VP & Chief Financial Officer	Mr	Giblin	John		1-423-535-4884					John_Giblin@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	01/10/2013	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	CMS Casework Communication Contact	Manager Operations		Flagg	Kendra		1-423-535-7524				1-423-535-5498	Kendra_Flagg@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/17/2019	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Coordination of Benefits Contact	Manger Revenue Reconciliation		Camp	Jan		1-423-535-3639					jan_camp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/29/2017	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Customer Service Operations Contact	Manager Operations		Walters	Karen		1-423-535-7696					Karen_Walters@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	03/31/2015	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Government Relations Contact	Medicare Compliance Officer	Mrs.	Womble	Charriet		1-615-347-9580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Hospice Contact	Supervisor, Medicare Advantage Revenue Reconciliat		Cross	Jennifer	R	1-423-535-5969	5969			1-423-535-5498	Jennifer_Cross@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/07/2018	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Medicare Compliance Officer	Medicare Compliance Officer	Mrs	Womble	Charriet		1-615-347-9580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Part D Exceptions Contact	Manager Coverage Reviews 1		Moss	Portia							Portia_Moss@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/08/2019	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active	1-800-831-2583				PPO - BBA		C	Atlanta
H7917	Pharmacy Network Management Contact	Advisor Network Products CVS		Lowe	David		1-480-744-9231				1-877-387-5800	David.Lowe2@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/20/2021	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7917	Pharmacy Technical Help Desk Contact	Vendor Management		Horton	Kasena							Kasena.Horton@CVSHealth.com	2401 Cherahala  Blvd		Knoxville	TN	37932	12/21/2021	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active	1-866-693-4620				PPO - BBA		C	Atlanta
H7917	Plan to Plan Reconciliation Contact	Business Analyst Associate		Stinnett	James		1-423-535-1624					P2PAdministration_GM@bcbst.com	Attn: P2P Coordinator	1 Cameron Hill Circle Suite 0050	Chattanooga	TN	37402-0050	02/07/2018	2023	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Atlanta
H7925	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/05/2020	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H7925	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7925	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H7925	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY INDIANA, INC.	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7993	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H7993	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7993	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H7993	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8003	Automated TrOOP Balance Transfer Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Best Available Evidence Contact	Director Operations		Ortiz	Jason		1-803-264-3910				1-803-264-9581	Jason.Ortiz@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Chief Financial Officer	VP & CFO, BCBS Div	Mrs.	Srulevich	Heather		1-803-264-9488					Heather.Srulevich@BCBSSC.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	10/26/2017	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	CMS Casework Communication Contact	Manager - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Coordination of Benefits Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Customer Service Operations Contact	Director Operations		Ortiz	Jason		1-803-264-3910				1-803-264-9581	jason.ortiz@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Government Relations Contact	Compliance Officer		Pierstorff	Joel		1-803-264-1971				1-803-264-4050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Hospice Contact	Supervisor - Medicare Advantage Operations		DeWitt	Tanika		1-803-264-1103					tanika.dewitt@bcbssc.com	1-20 @ Alpine Rd.	AG-780	Columbia	SC	29223	10/25/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Medicare Compliance Officer	Compliance Officer	Mr.	Pierstorff	Joel		1-803-264-1971				1-803-264-4050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	01/05/2022	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Part D Exceptions Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris						1-803-870-8162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/31/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active	1-803-264-5355				PPO - BBA		C	Atlanta
H8003	Pharmacy Network Management Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		1-803-264-4347				1-803-870-8162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8003	Pharmacy Technical Help Desk Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris							Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/31/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active	1-855-540-5951				PPO - BBA		C	Atlanta
H8003	Plan to Plan Reconciliation Contact	Banking Supervisor		Squirewell	Quentin		1-803-264-4128					quentin.squirewell@bcbssc.com	I-20 at Alpine Road	AX-A31	Columbia	SC	29219	03/10/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					PPO - BBA		C	Atlanta
H8010	Automated TrOOP Balance Transfer Contact	Finance Manager		Harte	Declan		1-253-306-7269					declan.harte@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	04/07/2022	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Best Available Evidence Contact	Enrollment Dir	Ms	Newman	Jennifer		1-754-245-6377					jennifer.newman@cloverhealth.com	30 Montgomery Street, 15th floor		Jersey City	NJ	07302	07/18/2022	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Chief Financial Officer	Interim CFO	Mr.	Herbers	Mark		1-630-862-9384				1-201-255-4173	mark.herbers@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	10/28/2021	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	CMS Casework Communication Contact	Compliance Director	Mr.	Davis	Robert		1-201-320-0506					robert.davis@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	11/08/2019	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Coordination of Benefits Contact	Enrollment Director	Ms.	Newman	Jennifer		1-754-245-6377					jennifer.newman@cloverhealth.com	30 Montgomery Street , 15th floor		Jersey City	NJ	07302	07/18/2022	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Customer Service Operations Contact	Chief Operating Officer	Ms	Reynoso	Jamie		1-201-432-2133				1-201-255-4173	jamie.reynoso@Cloverhealth.com	30 Montgomery  St		Jersey City	NJ	07302	07/18/2022	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Government Relations Contact	Chief Compliance Officer	Mrs.	Richey	Wendy		1-551-225-2014				1-201-255-4173	wendy.richey@cloverhealth.com	3401 Mallory Lane Ste 210		Franklin	TN	37067	10/28/2021	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Hospice Contact	COO	Ms	Reynoso	Jamie		1-201-432-2133				1-201-858-7355	jamie.reynoso@Cloverhealth.com	30 Montgomery  St		Jersey City	NJ	07302	03/22/2021	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Richey	Wendy		1-551-225-2014				1-201-255-4173	wendy.richey@cloverhealth.com	3401 Mallory Lane Ste 210		Franklin	TN	37067	10/28/2021	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Part D Exceptions Contact	VP of Pharmacy	Mr	Pica	Michael						1-201-255-4173	mike.pica@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	02/10/2018	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active	1-201-432-2133				HMO - Health Maintenance Organization		C	New York
H8010	Pharmacy Network Management Contact	SV Pharmacy	Mr.	Pica	Mike		1-201-432-2133				1-480-314-6023	mike.pica@Cloverhealth.com	30 Montgomery  St	MC080	Jersey City	NJ	07302	02/12/2020	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8010	Pharmacy Technical Help Desk Contact	VP of Pharmacy	Mr	Pica	Michael							mike.pica@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	06/21/2021	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H8010	Plan to Plan Reconciliation Contact	Sr Accounting Manager	Mr	Malone	Eliot		1-201-523-3725					eliot.malone@cloverhealth.com	30 Montgomery Street, 15th Floor		Jersey City	NJ	07302	02/25/2021	2023	CLOVER HMO OF NEW JERSEY, INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8014	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	12/06/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Part D Exceptions Contact	Sr Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	1-614-336-3326				PPO - BBA		C	Chicago
H8014	Pharmacy Network Management Contact	Provider Contracting Principal, Retail Strategy an		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8014	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms	Monroe	LaTasha							Latsha_Monroe@express-scripts.com	13051 N Telecom Pkwy	Suite 150	Temple Terrace	FL	33637	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H8014	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/22/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H8019	Automated TrOOP Balance Transfer Contact			Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Best Available Evidence Contact	Manager - Enrollment & Billing		Kaderabek	Kay		1-608-828-1976					Kay.Kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Chief Financial Officer	Chief Financial Officer	Mr	Ruplinger	Randy		1-608-827-4030					hpmscfo.inbox@deancare.com	1277 Deming Way		Madison	WI	53717	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	CMS Casework Communication Contact	Director of Claims Operations & Customer Relations		Genin	William	J	1-608-827-4486					William.Genin@deancare.com	1277 Deming Way		Madison	WI	53717	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Coordination of Benefits Contact	Manager - Enrollment & Billing		Kaderabek	Kay		1-608-828-1976					Kay.Kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Customer Service Operations Contact	Director of Claims Operations  Customer Relations		Genin	William	J	1-608-827-4486					William.Genin@deancare.com	1277 Deming Way		Madison	WI	53717	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Government Relations Contact	General Counsel, Director of Legal Services		Sutton	Dean		1-608-827-4301					dean.sutton@deancare.com	1277 Deming Way		Madison	WI	53717	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Hospice Contact	Medicare Compliance Officer		Specht	Jacob		1-608-827-4209					Jacob.Specht@deancare.com	1277 Deming Way		Madison	WI	53717	03/01/2022	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Specht	Jacob		1-608-827-4209					Jacob.Specht@deancare.com	1277 Deming Way		Madison	WI	53717	03/01/2022	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Part D Exceptions Contact	Manager, Medicare Part D Clinical Programs	Mr	Kurzynski	Adam						1-920-221-4622	Adam.Kurzynski@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-920-221-4122				HMO - Health Maintenance Organization		C	Chicago
H8019	Pharmacy Network Management Contact	Associate Director, Pharmacy Network Management		Miller	Steven		1-920-221-4272				1-920-221-4772	steven.miller@navitus.com	1025 W Navitus Drive		Appleton	WI	54913	02/05/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8019	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-866-595-1975	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/09/2021	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-866-270-3877				HMO - Health Maintenance Organization		C	Chicago
H8019	Plan to Plan Reconciliation Contact	Associate Actuary		Lowenberg	Nicholas		1-608-827-4157					nicholas.lowenberg@deancare.com	1277 Deming Way		Madison	WI	53717	02/25/2020	2023	SSM HEALTH PLAN	Local CCP	WellFirst Health	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8026	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Best Available Evidence Contact	Sr. Compliance Lead		Alexander	Angela		1-313-236-5033					AlexanderA9@aetna.com	28588 Northwestern Hwy	Suite 380B	Southfield	MI	48034	11/16/2020	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	05/04/2020	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	CMS Casework Communication Contact	Lead Director		Leskovac	Tara		1-614-563-7807					leskovact@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/20/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Coordination of Benefits Contact	Phamacy Director		Vergil	Gina		1-402-699-7768					VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	01/14/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		1-866-600-2139					PhillipsL1@aetna.com	7400 Camous Road		New Albany	OH	43054	01/02/2020	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Government Relations Contact	Vice President, Duals Markets	Mr	Smith	Jason		1-614-551-4237					SmithT25@aetna.com	4500 E. Cotton Center Blvd.		Phoenix	AZ	85040	01/14/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Hospice Contact	Director, Service Operations		Truitt	Michelle		1-717-671-6847					MLTruitt@aetna.com	3721 TecPort Drive		Harrisburg	PA	17111	07/01/2020	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Part D Exceptions Contact	Phamacy Director		Vergil	Gina							VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	01/14/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-402-699-7768				Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Pharmacy Network Management Contact	Phamacy Director		Vergil	Gina		1-402-699-7768					VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	01/14/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Pharmacy Technical Help Desk Contact	Phamacy Director		Vergil	Gina							VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	01/18/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-855-319-6287				Demo Risk Option C	MMP HMO Demo	C	Chicago
H8026	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA BETTER HEALTH OF MICHIGAN INC.	Demo	Aetna Better Health Premier Plan	Medicare-Medicaid Plan HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	3133 E Washington Rd.		Washington	NH	03280	01/21/2021	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Government Relations Contact	MIL- Director, Government Contracts		Welton	Michael		1-888-562-5442					michael.welton@molinahealthcare.com	1520 Kensington Rd		Oak Brook	IL	60523	12/31/2019	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				Demo Risk Option C	MMP HMO Demo	C	Chicago
H8046	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF ILLINOIS, INC.	Demo	Molina Healthcare of Illinois	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8048	Automated TrOOP Balance Transfer Contact	Regional Director of Operations	Mrs	Hulon	Amber		1-727-417-5819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	Best Available Evidence Contact	Executive Assistant		Anderson	Brooke		1-559-960-5671					BAnderson@kinshiphs.com	1099 Sylmar Ave Apt 203		Clovis	CA	93612	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	Chief Financial Officer	CEO	Mr	Enderle	John		1-860-655-9211					jenderle@kinshiphs.com	31 Andreis Trail		South Windsor	CT	06074	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	CMS Casework Communication Contact	Regional Director of Operations	Mrs	Hulon	Amber		1-727-417-5819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	Coordination of Benefits Contact	Regional Director of Operations	Mrs	Hulon	Amber		1-727-417-5819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	Customer Service Operations Contact	Director of Operations and Implementation	Mr.	Beijer	David		1-828-702-9191					dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	Government Relations Contact	Chief Strategy Officer	Ms.	Kohn	Judy		1-917-270-0599					jkohn@kinshiphs.com	260 Pearsall place		Lawrence	NY	11559	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	Medicare Compliance Officer	Director of Operations and Implementation	Mr	Beijer	David		1-828-702-9191					dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	Part D Exceptions Contact	Regional Director of Operations	Mrs	Hulon	Amber							ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending	1-727-417-5819				PACE - Nat		C	Chicago
H8048	Pharmacy Network Management Contact	Director of Operations and Implementation	Mr	Beijer	David		1-828-702-9191					dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8048	Pharmacy Technical Help Desk Contact	Director of Operations and Implementation	Mr.	Beijer	David						1-559-238-9224	dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending	1-800-639-1305				PACE - Nat		C	Chicago
H8048	Plan to Plan Reconciliation Contact	Executive Assistant		Anderson	Brooke		1-559-960-5671					BAnderson@kinshiphs.com	1099 Sylmar Ave Apt 203		Clovis	CA	93612	08/04/2022	2023	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8064	Automated TrOOP Balance Transfer Contact	VP, Chief Compliance Officer	Ms.	Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@Healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Best Available Evidence Contact	Manager of Pharmacy Services	Ms.	Lukow	Christine		1-910-687-6569				1-910-687-6506	Christine.Lukow@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	01/11/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Chief Financial Officer	Chief Financial Officer	Mr.	Bradford	Jerry		1-217-902-9002				1-217-902-9740	Jerry.Bradford@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	10/29/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	CMS Casework Communication Contact	Manager of Regulatory and Medicare Compliance	Ms	Russell	Petrina		1-910-687-6560				1-910-687-6506	Petrina.Russell@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Coordination of Benefits Contact	Medicare Operations Manager		Rentmeester	Kurt		1-910-687-6629				1-910-687-6506	Kurt.Rentmeester@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	01/11/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Customer Service Operations Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Government Relations Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9740	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Hospice Contact	Manager of Pharmacy	Ms.	Lukow	Christine		1-217-902-8224				1-217-902-9794	christine.lukow@firstcarolinacare.com	42 Memorial Dr.		Pinehurst	NC	28374	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Medicare Compliance Officer	VP, Chief Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224					hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Part D Exceptions Contact	Manager of Pharmacy Services	Ms.	Lukow	Christine						1-910-687-6506	Christine.Lukow@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	01/11/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active	1-910-687-6569				PPO - BBA		C	Chicago
H8064	Pharmacy Network Management Contact	VP, Chief Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224					hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8064	Pharmacy Technical Help Desk Contact	Manager of Pharmacy	Ms.	Lukow	Christine						1-217-902-9794	christine.lukow@firstcarolinacare.com	42 Memorial Drive		Pinehurst	NC	28374	01/27/2021	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active	1-800-880-1188	2			PPO - BBA		C	Chicago
H8064	Plan to Plan Reconciliation Contact	Finance Manager-Risk Adjustment		Tizora	Elizabeth		1-217-902-9469					elizabeth.tizora@healthalliance.org	3310 Fields South Drive		Champaign,	IL	61822	02/14/2022	2023	FIRSTCAROLINACARE INSURANCE COMPANY	Local CCP	FirstMedicare Direct	Local PPO		The Carle Foundation	583	Yes	Active					PPO - BBA		C	Chicago
H8067	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Dr	Ford	James	E	1-443-275-9801					jford@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Best Available Evidence Contact	Director of Partner Development	Ms	Radice	Sue		1-410-991-3213				1-844-462-3091	sradice@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Chief Financial Officer	CFO	Mr	Persinger	Keith		1-410-456-3946					kpersinger@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	12/29/2020	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	CMS Casework Communication Contact	Chief Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/03/2020	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Coordination of Benefits Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/30/2019	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Customer Service Operations Contact	Sr. Director of Operations	Mr.	Brain	Jay		1-240-367-2626					JBrain@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/29/2021	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Government Relations Contact			Grindrod	Rick		1-410-424-0772					rgrindrod@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Hospice Contact	Account Manager	Ms.	Sousa	Ana		1-215-872-4933					asousa@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	07/16/2020	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Medicare Compliance Officer	Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	11/10/2022	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Part D Exceptions Contact	Associate Vice President	Ms	Lavignette	Amanda							alavignette@envsionrx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	11/10/2020	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Philadelphia
H8067	Pharmacy Network Management Contact	Director Pharmacy Network Development & Operations	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8067	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-844-846-8007				HMO - Health Maintenance Organization		C	Philadelphia
H8067	Plan to Plan Reconciliation Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/30/2019	2023	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8070	Automated TrOOP Balance Transfer Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	10/25/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Best Available Evidence Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					mjohnson4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	10/25/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Chief Financial Officer	SVP and Chief Financial Officer	Ms.	Monsrud	Beth		1-612-676-3217				1-612-676-6501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/24/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	CMS Casework Communication Contact	A&G Regulatory and Compliance Specialist		Wood	Nakia		1-612-294-5668					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Coordination of Benefits Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Customer Service Operations Contact	CS Support Services Sr Manager		Vang	Pakou		1-612-676-3585					pvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Government Relations Contact	Federal Government Relations Specialist		Vang	Julie		1-612-294-5654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/30/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Hospice Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051					pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	McMahon	Jane		1-612-456-7817					jmcmahon@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/15/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Part D Exceptions Contact	Vice President Pharmacy Management		Mitsch	Patrick						1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active	1-612-294-5051				PPO - BBA		C	Chicago
H8070	Pharmacy Network Management Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8070	Pharmacy Technical Help Desk Contact	Director, Customer Service		Warren	Mark							mwarren@express-scripts.com	6625 West 78th Street		Minneapolis	MN	55439	01/24/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H8070	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		1-612-676-3213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/24/2022	2023	UCARE MINNESOTA	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8082	Automated TrOOP Balance Transfer Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Best Available Evidence Contact			Hall	Kristi		1-650-336-0300					kristi.hall@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	06/10/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Chief Financial Officer		Mr.	Epstein	Ethan		1-203-695-1178					ethan.epstein@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	CMS Casework Communication Contact			Goel	Jyotika		1-619-746-2459					jyotika.goel@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Coordination of Benefits Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Customer Service Operations Contact			Simon	Jillian		1-310-429-6136					jillian.simon@welbehealth.com	582 E. Harding Way		Stockton	CA	95204	07/29/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Government Relations Contact			Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Medicare Compliance Officer		Ms.	Lee	Elizabeth		1-650-514-1390					elizabeth.lee@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part D Exceptions Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	1-800-637-3187				PACE - Nat		C	San Francisco
H8082	Pharmacy Network Management Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Pharmacy Technical Help Desk Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	1-800-637-3187				PACE - Nat		C	San Francisco
H8082	Plan to Plan Reconciliation Contact			Grant	Alexsa		1-310-963-5394					alexsa.grant@welbehealth.com	340 S. Lemon Ave #4051		Walnut	CA	91789	04/21/2022	2023	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8087	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H8087	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8087	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H8087	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANADENTAL INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H8093	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/18/2020	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H8093	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	09/07/2021	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-833-665-5420				HMO - Health Maintenance Organization		C	Dallas
H8093	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8095	Automated TrOOP Balance Transfer Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Best Available Evidence Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Chief Financial Officer	SVP, Controller	Mr.	Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/15/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	CMS Casework Communication Contact	Compliance Consultant		White	Jasmin		1-248-665-4235					JWhite4@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/23/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Coordination of Benefits Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	03/22/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Customer Service Operations Contact	Director, Workforce Management, Analytics, & Supp		Weber	Julie		1-313-225-0555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	11/15/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Government Relations Contact	Manager, Program Oversight		Martell	Stacey		1-313-806-5905					smartell@bcbsm.com	1000 Town Center		Southfield	MI	48075	02/15/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Hospice Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Part D Exceptions Contact	Director, Medicare Programs		Frank	Jesica							frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-855-344-0930				HMO - Health Maintenance Organization		C	Chicago
H8095	Pharmacy Network Management Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8095	Pharmacy Technical Help Desk Contact	Director, Medicare Programs		Frank	Jesica							frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	06/01/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-600-8065				HMO - Health Maintenance Organization		C	Chicago
H8095	Plan to Plan Reconciliation Contact	SVP, Controller	Mr.	Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/15/2021	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	Local CCP	Wellmark Advantage Health Plan	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8096	Automated TrOOP Balance Transfer Contact	Business Manager	Mrs.	Beach	Megan	F	1-434-200-6303					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/31/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Best Available Evidence Contact	Quality Manager	Mrs	Woodley	Kimberly		1-434-200-6516					Kimberly.Woodley@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/19/2018	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Chief Financial Officer	Sr. Vice President & CFO	Mr	Davenport	Douglas	C	1-434-200-4708					doug.davenport@centrahealth.com	1901 Tate Springs Rd.		Lynchburg	VA	24501	12/07/2020	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	CMS Casework Communication Contact	Site Director	Mrs.	Boyd	Jennifer	H	1-434-200-6320					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	09/02/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Coordination of Benefits Contact	Business Manager	Mrs.	Beach	Megan	F	1-434-200-6303					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/31/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Customer Service Operations Contact	Site Director	Mrs.	Boyd	Jennifer	H	1-434-200-6320					jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	09/02/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Government Relations Contact	Site Director	Mrs	Boyd	Jennifer	H	1-434-200-6320					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	09/02/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Medicare Compliance Officer	Business Manager	Mrs.	Beach	Megan	F	1-434-200-6303					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	09/06/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Exceptions Contact	Business Manager	Mrs.	Beach	Megan	F						megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/31/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active	1-888-316-9540				PACE - Nat		C	Philadelphia
H8096	Pharmacy Network Management Contact	Business Manager	Mrs.	Beach	Megan	F	1-434-200-6303					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/31/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Pharmacy Technical Help Desk Contact	Centra PACE Pharmacy Technical Help Desk	Mr	Hawkins	Patrick							patrick.hawkins@centrahealth.com	407 Federal Street, Suite B		Lynchburg	VA	24504	06/03/2013	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active	1-434-200-2148				PACE - Nat		C	Philadelphia
H8096	Plan to Plan Reconciliation Contact	Business Manager	Mrs.	Beach	Megan	F	1-434-200-6516					megan.beach@centrahealth.com	Centra PACE	407 Federal Street	Lynchburg	VA	24504	08/31/2022	2023	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8099	Automated TrOOP Balance Transfer Contact	Business Office Manager		Cox	Terra		1-970-508-7737				1-970-252-0166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	Best Available Evidence Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	Chief Financial Officer	VP of Financial Services	Ms	Gavin	Nancy		1-612-428-7840				1-952-941-0428	ngavin@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	CMS Casework Communication Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	Coordination of Benefits Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	Customer Service Operations Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	Government Relations Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	Medicare Compliance Officer	PACE Director of Program Integrity/Compliance	Ms.	Linnell	Kathryn	R	1-970-508-7757				1-866-829-9949	klinnell@voa.org	2377 Robins Way		Montrose	CO	81401	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	Part D Exceptions Contact	Executive Director	Mr.	Robbins	Ken						1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending	1-517-319-0690				PACE - Nat		C	Chicago
H8099	Pharmacy Network Management Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8099	Pharmacy Technical Help Desk Contact	Executive Director	Mr.	Robbins	Ken						1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending	1-517-319-0690				PACE - Nat		C	Chicago
H8099	Plan to Plan Reconciliation Contact	Executive Director	Mr.	Robbins	Ken		1-517-319-0690				1-517-319-0650	krobbins@voa.org	1921 East Miller Road		Lansing	MI	48911	12/23/2022	2023	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H8121	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/02/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H8121	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8121	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H8121	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8130	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H8130	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8130	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H8130	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF FLORIDA, INC.	Local CCP	Molina Healthcare of Florida	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8133	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Denver
H8133	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8133	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				HMO - Health Maintenance Organization		C	Denver
H8133	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Bush	Stephen		1-254-298-3568				1-254-298-3005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Best Available Evidence Contact	Director HP Enrollment		Wilson	Deanna		1-254-298-3340					Deanna.Wilson@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/24/2022	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Chief Financial Officer	Chief Financial Officer	Mr.	Bush	Stephen	P	1-254-298-3568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	01/20/2017	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	CMS Casework Communication Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	12/28/2021	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Coordination of Benefits Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	12/28/2021	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Customer Service Operations Contact	Manager, Customer Advocacy		Perkins	Michelle		1-254-298-3393					Michelle.Perkins@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Government Relations Contact	Compliance Officer		Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	12/28/2021	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Hospice Contact	Director Pharmacy Operations		Luebbert	Charlotte		1-254-298-6151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/09/2018	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Medicare Compliance Officer	Compliance Officer	Mrs	Cornett	Amy		1-254-298-3211					Amy.Cornett@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	12/28/2021	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Part D Exceptions Contact	Manager Pharmacy Admin.		Thomas	Megan							Megan.Cunningham@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/15/2019	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active	1-254-298-6108				HMO - Health Maintenance Organization		C	Dallas
H8142	Pharmacy Network Management Contact	Director Pharmacy Operations		Luebbert	Charlotte		1-254-298-6151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/09/2018	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8142	Pharmacy Technical Help Desk Contact	OptumRx		Rx	Optum								1600 McConnor Parkway		Schaumburg	IL	60173-6801	01/14/2019	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active	1-844-230-9357				HMO - Health Maintenance Organization		C	Dallas
H8142	Plan to Plan Reconciliation Contact	Chief Financial Officer		Bush	Stephen		1-254-298-3568				1-254-298-3005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	02/16/2022	2023	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Holdings	588	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8145	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	1-502-580-9138				PFFS - Private Fee for Service		C	Kansas City
H8145	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	1-800-865-8715				PFFS - Private Fee for Service		C	Kansas City
H8145	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8166	Automated TrOOP Balance Transfer Contact	Manager, Enrollment & Billing	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Chief Financial Officer	CFO Highmark Health Plan	Mr.	Veach	Daryl		1-412-544-7531					Daryl.Veach@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/14/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	1-412-544-4579				1-717-635-4209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		1-412-544-4417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		1-814-871-6712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Government Relations Contact	SVP, Government Affiars	Mr.	Warfel	Michael	G	1-717-302-3979					michael.warfel@highmark.com	1800 Center St.		Camp Hill	PA	17011	03/18/2022	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Hospice Contact	Intake Coordinator		Welker	Jessica		1-717-888-3043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		1-412-544-7031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite P4207	Pittsburgh	PA	15222	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active	1-800-600-2227				PPO - BBA		C	Philadelphia
H8166	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8166	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/08/2022	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active	1-800-922-1557				PPO - BBA		C	Philadelphia
H8166	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	1-717-302-2748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 890407	Camp Hill	PA	17089-0407	01/26/2021	2023	HIGHMARK BCBSD, INC.	Local CCP	Highmark Inc.	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Philadelphia
H8173	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				HMO - Health Maintenance Organization		C	New York
H8173	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8173	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H8173	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H8176	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8176	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H8176	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8181	Automated TrOOP Balance Transfer Contact	Manager PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755					EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/02/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Best Available Evidence Contact	Enrollment and Billing Manager	Ms.	Ware	Anita		1-508-330-9500					Anita.Ware@advantasure.com	134 Turnpike Road		Southborough	MA	01772	02/08/2019	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Chief Financial Officer	VP Actuarial, Underwriting & Data Analytics	Mr	Konnath	Steven		1-402-982-8862					Steven.Konnath@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/02/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	CMS Casework Communication Contact	Client Relations Compliance Consultant	Ms.	Leon	Megan		1-248-665-4675					mleon@bcbsm.com	600 Lafayette East	TC1301	Detroit	MI	48226	12/21/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Coordination of Benefits Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755					COBMedD@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/02/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Customer Service Operations Contact	Director, Workforce Management, Analytics & SUppor		Weber	Julie		1-888-505-2022					jweber@bcbsm.com	500 Lafayette East		Detroit	MI	48226	04/19/2021	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Government Relations Contact	Chief Actuary and Analytics Officer	Mr.	Konnath	Steven		1-402-982-8862					steven.konnath@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	12/19/2022	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Hospice Contact	Pharmacy Program Manager	Mr.	Keiser	Michael		1-402-982-7700					Michael.Keiser@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	03/25/2019	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Medicare Compliance Officer	MA Compliance Officer	Ms.	Vaughn	Shannon		1-402-982-7846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	06/18/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/29/2021	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active	1-800-693-6703				PPO - BBA		C	Kansas City
H8181	Pharmacy Network Management Contact	AVP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/02/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8181	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/29/2021	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active	1-855-457-1351				PPO - BBA		C	Kansas City
H8181	Plan to Plan Reconciliation Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		1-402-982-8790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2023	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active					PPO - BBA		C	Kansas City
H8189	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H8189	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8189	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H8189	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8197	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Government Relations Contact	Vice President, Government Contracts		Letcher	Kelsey		1-888-562-5442					Kelsey.Letcher@molinahealthcare.com	84 NE Loop 410		San Antonio	TX	78216	10/18/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	jennifer.browning@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/31/2020	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				Demo Risk Option C	MMP HMO Demo	C	Dallas
H8197	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF TEXAS, INC.	Demo	Molina Healthcare of Texas	Medicare-Medicaid Plan HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8211	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H8211	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8211	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H8211	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8213	Automated TrOOP Balance Transfer Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		1-215-937-5325					nortiz@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	12/30/2020	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		1-484-497-1171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	12/26/2018	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Chief Financial Officer	Chief Financial Officer	Mr.	Burgoyne	Michael		1-215-937-8875					mburgoyne@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	100 Stevens Drive	Philadelphia	PA	19113	04/04/2019	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	CMS Casework Communication Contact	Medicare QA Contract Acct Mgr	Ms.	Fine	Nicole		1-484-496-7479					nfine@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	10/17/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Coordination of Benefits Contact	Manager, Provider Network Oversight	Ms.	Williams	Kathy		1-843-746-7499					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		1-267-298-1794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	08/04/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Government Relations Contact	Director, Public Policy		Cozzo	Mr.Steven		1-215-937-8236					scozzo@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	11/17/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Hospice Contact	Director of Phamarcy, Medicare	Ms.	Shepard	Jen		1-215-937-8685					jshepard1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	11/17/2021	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Dupre	Colleen		1-203-506-8413					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	100 Stevens Drive, 2flr.	Philadelphia	PA	19113	12/08/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						1-215-863-5100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	12/26/2018	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-215-863-6483				Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Pharmacy Network Management Contact	Director	Ms.	Leal	Avelina		1-215-863-6540					aleal@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	12/30/2020	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Pharmacy Technical Help Desk Contact	Director, Service Operations	Ms.	Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	11/05/2019	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	1-855-327-0511				Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8213	Plan to Plan Reconciliation Contact	Director, Medicare Performance Management	Mr.	Kindred	Amanda		1-248-404-5991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	08/10/2022	2023	SELECT HEALTH OF SOUTH CAROLINA, INC.	Demo	FIRST CHOICE VIP CARE PLUS	Medicare-Medicaid Plan HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Atlanta
H8220	Automated TrOOP Balance Transfer Contact			Rolfe	Tammy		1-321-269-4240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Best Available Evidence Contact			Killian	Joseph		1-513-382-6688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Chief Financial Officer		Ms.	Forbes	Angela		1-321-615-8762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	CMS Casework Communication Contact			Rolfe	Tammy		1-321-269-4240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Coordination of Benefits Contact			Rolfe	Tammy		1-321-269-4240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Customer Service Operations Contact			Rolfe	Tammy		1-321-269-4240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Government Relations Contact			Killian	Joseph		1-513-382-6688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Medicare Compliance Officer		Ms.	Rolfe	Tammy		1-321-269-4240					trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Part D Exceptions Contact			Rolfe	Tammy							trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending	1-207-242-5386				PACE - Nat		C	Atlanta
H8220	Pharmacy Network Management Contact			Rolfe	Tammy		1-321-269-4240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Pharmacy Technical Help Desk Contact			Rolfe	Tammy							trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/29/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending	1-207-242-5386				PACE - Nat		C	Atlanta
H8220	Plan to Plan Reconciliation Contact			Rolfe	Tammy		1-321-269-4240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2023	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8225	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H8225	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8225	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H8225	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	CENTENE VENTURE COMPANY FLORIDA	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8229	Automated TrOOP Balance Transfer Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Best Available Evidence Contact	Engagement Delivery Director	Ms.	Riswadkar	Nicola		1-314-600-1998					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Chief Financial Officer	Chief Financial Officer	Mr.	Grabski	Ben		1-763-300-7611					bgrabski@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	CMS Casework Communication Contact	Sr. Director Compliance	Mr.	Whitbeck	Britton		1-314-209-3989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/28/2022	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Coordination of Benefits Contact			Inquiries	COB		1-855-425-0457					COBInquiry@lumeris.com	P O BOX 5907		TROY	MI	48007	12/06/2022	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Customer Service Operations Contact	Vice President, Engagement	Ms.	Meyerhoffer	Linda		1-636-686-9682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		1-314-209-2717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Hospice Contact	Director, Pharmacy		Cruz	Jennifer		1-314-770-3556					pharmacy@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Medicare Compliance Officer	VP Internal Audit and Chief Compliance Officer	Ms.	Venable	Erin		1-314-209-3957					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Part D Exceptions Contact		Ms.	Byers	June							June.Byers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				PPO - BBA		C	Kansas City
H8229	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	Cruz	Jennifer		1-314-770-3556					jcruz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8229	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	1-844-513-6003				PPO - BBA		C	Kansas City
H8229	Plan to Plan Reconciliation Contact	Manager, Client Payments		Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2021	2023	ESSENCE HEALTHCARE OF GEORGIA, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Kansas City
H8244	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				PPO - BBA		C	San Francisco
H8244	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8244	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				PPO - BBA		C	San Francisco
H8244	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H8293	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-614-336-3326				HMO - Health Maintenance Organization		C	Chicago
H8293	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8293	Pharmacy Technical Help Desk Contact			Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	12/20/2021	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H8293	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (VA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8298	Automated TrOOP Balance Transfer Contact	Director, PBM Ops.	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	09/28/2022	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Best Available Evidence Contact	Supervisor, Govt.. Programs		Achoe	Kisha		1-973-466-7328					BAEINQUIRIES@horizonblue.com	3 Penn Plaza East, PP-12L		Newark	NJ	07105	07/31/2018	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Chief Financial Officer	SVP & Chief Financial Offcr.	Mr.	Rosenberg	David		1-973-466-4600					david_rosenberg@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/02/2022	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	CMS Casework Communication Contact	Director, GP Operations		Maramraju	Venkata		1-609-537-2113					venkata.maramraju@horizonblue.com	1700 American Boulevard		Pennington	NJ	08534	01/03/2022	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Coordination of Benefits Contact	Director, PBM Ops	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	09/28/2022	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Customer Service Operations Contact	Director, Service Operations	Mr.	Yanek	John		1-518-220-8000					john_yanek@horizonblue.com	3 Penn Plaza		Newark	NJ	07105	06/13/2022	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Government Relations Contact	Director, Regulatory Compliance/ MCO	Mr.	McGrady	Daniel		1-732-539-3680					daniel_mcgrady@horizonblue.com	1700 American Blvd.	HL-03	Pennington	NJ	08534	02/25/2022	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Hospice Contact	Director, Clinical Special Needs Plan		Smolij	Carol		1-856-638-3595					Carol_Smolij@horizonblue.com	250 Century Pkwy		Mt. Laurel	NJ	08054	04/04/2018	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Medicare Compliance Officer	Director, Reg. Requirements/ MCO	Mr	McGrady	Daniel		1-732-539-3680					daniel_mcgrady@horizonblue.com	1700 American Blvd.	HL-03	Pennington	NJ	08534	07/12/2021	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Part D Exceptions Contact	Director, Reg/Audit Response	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd		Eagan,	MN	55121	04/15/2021	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	New York
H8298	Pharmacy Network Management Contact	AVP, Network Mgmt	Ms	Conlin	Marci		1-612-777-2842					Marci.Conlin@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	04/15/2021	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8298	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	PRIME Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	09/28/2022	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active	1-800-391-1926				HMO - Health Maintenance Organization		C	New York
H8298	Plan to Plan Reconciliation Contact	Pharmacy Business Admin		Cunningham	Theresa		1-973-466-7886				1-973-466-4665	theresa_cunningham@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/22/2016	2023	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Local CCP	Horizon Blue Cross Blue Shield of New Jersey	HMO/HMOPOS		Horizon Mutual Holdings, Inc	126	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8330	Automated TrOOP Balance Transfer Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Best Available Evidence Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Chief Financial Officer	SVP Chief Financial Officer	Mr.	Kurpad	Umesh		1-781-612-1000	84968				umesh.kurpad@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	CMS Casework Communication Contact	Director, Appeals & Grievances	Ms.	Evans	Kathleen		1-617-972-9400	87204				kathleen.evans@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Coordination of Benefits Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Customer Service Operations Contact	Manager, Member Services	Ms.	Villatoro	Yesly		1-781-612-1000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Government Relations Contact	Chief Government Affairs Officer	Ms.	Lewis	Kristin		1-781-612-1000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Hospice Contact	Manager, Pharmacy Operations & Programs	Ms.	MacAuley	Jacqueline		1-781-612-1000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Medicare Compliance Officer	Medicaid Compliance Officer	Mr.	Camper	Stephen		1-781-612-1000	84759				stephen.camper@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-781-612-1000	82370			HMO - Health Maintenance Organization		C	Boston
H8330	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/06/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173-6801	12/08/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	1-855-524-0380				HMO - Health Maintenance Organization		C	Boston
H8330	Plan to Plan Reconciliation Contact	Manager, Finance Operations	Ms.	Olson	Rachel		1-781-612-1000	84360				rachel.olson@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8332	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	01/13/2020	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/13/2020	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/15/2020	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/13/2020	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H8332	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8332	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H8332	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA BETTER HEALTH OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8343	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H8343	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8343	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H8343	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8379	Automated TrOOP Balance Transfer Contact	Enrollment Coordinator		Rice	Lori		1-616-464-8667					PH-MedicareTrOOPContact@PriorityHealth.com	1231 East Beltline Ave NE	MS 1175	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Best Available Evidence Contact	Manager, Medicare Enrollment		Thomas	Sabrina		1-616-464-8578					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Chief Financial Officer	Chief Financial Officer	Mr	Gates	Nick	P	1-616-464-8144					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	CMS Casework Communication Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		1-917-841-7869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/14/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Coordination of Benefits Contact	Claims Manager		Ball	Jill		1-888-389-6648					CEOMedicare@priorityhealth.com	1239 East Beltline Ave NE	MS2205	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Customer Service Operations Contact	Customer Care Center Manager, Medicare		Storment	Joe		1-503-330-9550					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/07/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Government Relations Contact	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Hospice Contact	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Medicare Compliance Officer	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					charles.baker@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Part D Exceptions Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	1-800-466-6642				HMO - Health Maintenance Organization		C	Chicago
H8379	Pharmacy Network Management Contact	Director Pharmacy Operations		Chaffee	Jacob		1-616-575-6149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8379	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	1-800-466-6642				HMO - Health Maintenance Organization		C	Chicago
H8379	Plan to Plan Reconciliation Contact	Reconciliation & Billing Specialist		Bentley-Brown	Linda		1-616-464-8582				1-616-957-3420	linda.bentley-brown@priorityhealth.com	1231 East Beltline Ave NE	MS 1190	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Automated TrOOP Balance Transfer Contact	Senior Director of Pharmacy		Le	Hau		1-385-277-0417					hle@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	10/29/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Best Available Evidence Contact	Senior Director, Claims and Enrollment		Dugan	Todd		1-570-470-6267					tdugan@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	10/29/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Chief Financial Officer	Chief Financial Officer	Mr.	Mull	David		1-502-648-5138					dmull@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	06/06/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	CMS Casework Communication Contact	Director Appeals & Grievances	Ms.	Vega	Vanessa		1-954-699-4087					vvega@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	10/29/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Coordination of Benefits Contact	Senior Director, Claims and Enrollment		Dugan	Todd		1-570-470-6267					tdugan@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	10/29/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Customer Service Operations Contact	Director Contact Center Operations		Rivers-Moya	Elle		1-615-358-9050					erivers-moya@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	10/29/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Government Relations Contact	General Counsel		Jordan	Teresa		1-713-213-7534					tjordan@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	03/26/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Hospice Contact	Senior Director of Pharmacy		Le	Hau		1-385-277-0417					hle@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	10/29/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Kirchner	Rocio		1-615-504-7120					rkirchner@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	02/22/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Part D Exceptions Contact	Senior Director of Pharmacy		Le	Hau							hle@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	10/29/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active	1-385-277-0417				HMO - Health Maintenance Organization		C	Chicago
H8384	Pharmacy Network Management Contact	Director Pharmacy Network		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/08/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8384	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							tconn@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	03/26/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active	1-888-999-9999				HMO - Health Maintenance Organization		C	Chicago
H8384	Plan to Plan Reconciliation Contact	Senior Director of Pharmacy		Le	Hau		1-385-277-0417					hle@honestmedicalgroup.com	210 Athens Way	Suite 200	Nashville	TN	37228	10/29/2022	2023	HONEST HMO OF MICHIGAN LLC	Local CCP	Honest Health Plan	HMO/HMOPOS		Honest Medical Group LLC	789	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8385	Automated TrOOP Balance Transfer Contact	Senior Director of Government Programs	Ms.	Fuller	Rebecca		1-605-328-7007					rebecca.fuller@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Best Available Evidence Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Chief Financial Officer	Vice President of Finance	Mr.	Maude	Brian		1-605-328-6801					Brian.Maude@SanfordHealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	CMS Casework Communication Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		1-605-328-7182					aleesa.jansick@sanfordhealth.org	300 Cherapa place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Coordination of Benefits Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Customer Service Operations Contact	Director of Customer Service	Mr.	Ling	Ryan		1-605-312-7459					ryan.ling@sanfordhealth.org	300 N Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Government Relations Contact	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Hospice Contact	Director of Utilization Management	Ms.	Kanta	Misty		1-605-312-2788					misty.kanta@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part D Exceptions Contact	Manager, Prior Authorization	Ms.	Le	Christina						1-877-239-4565	rxsol_prior_auth_redirected_queue_DL@uhc.com	3515 Harbor Blvd		Costa Mesa	CA	92626	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	1-888-403-3398				PPO - BBA		C	Dallas
H8385	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway	Suite 200	Schaumburg	IL	60173-6801	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	1-844-642-9090				PPO - BBA		C	Dallas
H8385	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		1-605-312-9344					debora.harris@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	SANFORD HEALTH PLAN	Local CCP	Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8390	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		1-937-818-7479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Best Available Evidence Contact	Enrollment Team Lead	Mr.	Richardson	Kal		1-937-224-3300	3437			1-937-425-0909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	01/16/2020	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Chief Financial Officer	Chief Financial Officer	Mr.	Smart	Lawrence		1-937-531-3335					Lawrence.Smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/05/2021	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	CMS Casework Communication Contact	Director, Grievance and Appeals	Ms.	Acuna	Celeste		1-480-640-6815					celeste.acuna@caresource.com	P.O. Box 1947		Dayton	OH	45401	01/20/2022	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Coordination of Benefits Contact	Manager, Enrollment Operations	Mr.	Spivey	Michael		1-937-531-3682				1-937-487-0643	COBInquiry@caresource.com	230 N. Main St.		Dayton	OH	45402	04/15/2022	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Customer Service Operations Contact	Director, Customer Care		Cary	Lisa		1-937-232-6458					lisa.cary@caresource.com	40 W 2nd St		Dayton	OH	45402	10/04/2021	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Government Relations Contact	Director, Medicare Compliance Officer	Ms.	de Cardenas	Deonys		1-678-471-0101					deonys.decardenas@caresource.com	230 North Main Street		Dayton	OH	45402	05/04/2021	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Hospice Contact	Director, Enrollment	Mr.	Castro	Armando		1-937-531-2291					armando.castro@caresource.com	230 N Main St		Dayton	OH	45402	05/29/2020	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	de Cardenas	Deonys		1-678-471-0101					deonys.decardenas@caresource.com	230 N. Main St.		Dayton	OH	45402	05/04/2021	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/08/2022	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	New York
H8390	Pharmacy Network Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		1-937-818-7479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8390	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/22/2021	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H8390	Plan to Plan Reconciliation Contact	Manager, Accounting	Ms.	North	Sara		1-937-531-2669					CareSourceP2P@caresource.com	CareSource Accounting	PO Box 2208	Dayton	OH	45401	08/26/2020	2023	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8424	Automated TrOOP Balance Transfer Contact	COO	Ms	Smith	Wendy		1-712-224-7316				1-712-224-7253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	11/03/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	Best Available Evidence Contact	Executive Director		Ehlers	Randall		1-712-224-7223				1-712-224-7253	Randy.Ehlers@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	10/17/2019	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	Chief Financial Officer	Chief Financial Officer	Ms	Knapp	Leah		1-712-279-3824					Leah.Knapp@unitypoint.org	2720 Stone Park Blvd		Sioux City	IA	51104	08/10/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	CMS Casework Communication Contact	Executive Director	Mr	Ehlers	Randall		1-712-224-7223				1-712-224-7253	Randy.Ehlers@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/10/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	Coordination of Benefits Contact	COO	Ms	Smith	Wendy		1-712-224-7316				1-712-224-7253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	11/03/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	Customer Service Operations Contact	COO	Ms	Smith	Wendy		1-712-224-7316				1-712-224-7253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	11/03/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	Government Relations Contact	Executive Director		Ehlers	Randall		1-712-224-7223				1-712-224-7253	Randy.Ehlers@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	10/17/2019	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	Medicare Compliance Officer	Compliance Officer	Ms	Corell	Jennifer	S	1-515-574-6941					jennifer.corell@unitypoint.org	2720 Stone Park Blvd		Sioux City	IA	51104	02/11/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	Part D Exceptions Contact	COO		Smith	Wendy						1-712-224-7253	Wendy.smith@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	11/03/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active	1-888-722-3713				PACE - Nat		C	Kansas City
H8424	Pharmacy Network Management Contact	COO	Ms	Smith	Wendy		1-712-224-7316				1-712-224-7253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	11/03/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8424	Pharmacy Technical Help Desk Contact	COO		Smith	Wendy						1-712-224-7253	Wendy.smith@unitypoint.org	Siouxland PACE		Sioux City	IA	51103	11/03/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active	1-712-224-7256				PACE - Nat		C	Kansas City
H8424	Plan to Plan Reconciliation Contact	COO	Ms	Smith	Wendy		1-712-224-7316				1-712-224-7253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	11/03/2022	2023	SIOUXLAND PACE, INC.	National PACE	SIOUXLAND PACE, INC.	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	Kansas City
H8432	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H8432	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H8432	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	EMPIRE HEALTHCHOICE HMO, INC.	Local CCP	Empire BlueCross BlueShield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8439	Automated TrOOP Balance Transfer Contact	Regional Director of Operations	Mrs	KornBlatt	Georgia		1-570-371-7371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	12/28/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	Best Available Evidence Contact	Executive Assistant		Anderson	Brooke		1-559-960-5671					BAnderson@kinshiphs.com	1099 Sylmar Ave Apt 203		Clovis	CA	93612	10/05/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	Chief Financial Officer	CEO	Mr	Enderle	John		1-860-655-9211					jenderle@kinshiphs.com	31 Andreis Trail		South Windsor	CT	06074	10/05/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	CMS Casework Communication Contact	Regional Director of Operations	Mrs	KornBlatt	Georgia		1-570-371-7371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	12/28/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	Coordination of Benefits Contact	Regional Program Director	Mrs	KornBlatt	Georgia		1-570-371-7371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/10/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	Customer Service Operations Contact	Regional Program Director	Mrs	KornBlatt	Georgia		1-570-371-7371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/10/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	Government Relations Contact	Senior Vice President of Operations, Compliance an	Mrs	Melancon	Sharon		1-559-892-6640					smelancon@kinshiphs.com	300 Bessie Coleman Blvd		Waxahachie	TX	75165	12/28/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	Medicare Compliance Officer	Regional Program Director	Mrs	KornBlatt	Georgia		1-570-371-7371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	12/25/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	Part D Exceptions Contact	Regional Director of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	12/28/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending	1-570-371-7371				PACE - Nat		C	New York
H8439	Pharmacy Network Management Contact	Regional Program Director	Mrs	KornBlatt	Georgia		1-570-371-7371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/10/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8439	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						1-559-238-9224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/10/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending	1-570-371-7371				PACE - Nat		C	New York
H8439	Plan to Plan Reconciliation Contact	Executive Assistant		Anderson	Brooke		1-559-960-5671					BAnderson@kinshiphs.com	1099 Sylmar Ave Apt 203		Clovis	CA	93612	10/05/2022	2023	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE	Kinship PACE of Central Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	New York
H8452	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		1-937-818-7479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	11/08/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Best Available Evidence Contact	Enrollment Business Analyst	Mr.	Richardson	Kal		1-937-224-3300	3437			1-937-425-0909	kal.richardson@caresource.com	P. O. Box 8738		Dayton	OH	45401	03/06/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Chief Financial Officer	Chief Financial Officer	Mr.	Smart	Lawrence		1-937-531-3335					Lawrence.Smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/05/2021	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	CMS Casework Communication Contact	Director, Grievance & Appeals	Ms.	Acuna	Celeste		1-937-224-3300	2604				Celeste.Acuna@caresource.com	P.O. Box 1947		Dayton	OH	45401	03/06/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Coordination of Benefits Contact	Senior Manager, Enrollment Operations	Mr.	Spivey	Michael		1-937-531-3682					COBInquiry@caresource.com	230 N. Main St		Dayton	OH	45402	05/04/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Customer Service Operations Contact	Director, Customer Care	Ms.	Cary	Lisa		1-937-531-3313					lisa.cary@caresource.com	P. O. Box 8738		Dayton	OH	45401	10/04/2021	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Government Relations Contact	AVP, Ohio Compliance Officer	Ms.	Frazee	Margaux		1-937-531-3338					margaux.frazee@caresource.com	230 North Main Street		Dayton	OH	45402	03/06/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Hospice Contact	Director of Enrollment	Mr.	Castro	Armando		1-937-531-2291					Armando.Castro@caresource.com	230 N Main St		Dayton	OH	45402	03/06/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Medicare Compliance Officer	AVP, Ohio Compliance Officer	Ms.	Frazee	Margaux		1-937-531-3338					margaux.frazee@caresource.com	230 N. Main St.		Dayton	OH	45402	03/06/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	03/25/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active	1-614-336-3326				Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Pharmacy Network Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		1-937-818-7479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/24/2021	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active	1-800-922-1557				Demo Risk Option C	MMP HMO Demo	C	Chicago
H8452	Plan to Plan Reconciliation Contact	Accountant	Ms.	North	Sara		1-937-224-3300	2669				CareSourceP2P@CareSource.com	CareSource Accounting	P.O. Box 2208	Dayton	OH	45401	08/26/2020	2023	CARESOURCE OHIO, INC.	Demo	CareSource MyCare Ohio	Medicare-Medicaid Plan HMO/HMOPOS		CareSource	321	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H8457	Automated TrOOP Balance Transfer Contact			Rush	Jamie		1-561-690-1134					ESITroopTransfer@express-scripts.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Best Available Evidence Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N 107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Chief Financial Officer		Mr.	Granow	Les		1-561-444-0709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	CMS Casework Communication Contact			Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Coordination of Benefits Contact		Ms.	Burdelik	Dawn		1-561-815-3729					dawn.burdelik@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Customer Service Operations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Government Relations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Hospice Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Medicare Compliance Officer		Ms.	Lacey	Jennifer		1-813-367-7169					Jennifer.lacey@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						1-888-235-8551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-204-0016				HMO - Health Maintenance Organization		C	New York
H8457	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		1-800-204-0016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8457	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						1-888-235-8551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H8457	Plan to Plan Reconciliation Contact		Ms.	Zhai	Vicky		1-561-632-8915					Vicky.Zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8458	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	01/27/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H8458	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8458	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H8458	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	01/27/2021	2023	SILVERSUMMIT HEALTHPLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8492	Automated TrOOP Balance Transfer Contact	PharmD	Mrs.	Pardue	Lyndsey		1-501-590-0180				1-866-870-3080	lpardue@accesshealth.services	1 Riverfront Place	Suite 515	North Little Rock	AR	72114	12/05/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Best Available Evidence Contact	CEO	Mrs.	Psarellis	Dawn		1-225-964-8581					dpsarellis@dignityhmo.com	950 West Causeway Approach		Mandeville	LA	70471	05/08/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Chief Financial Officer	CFO	Mr.	Lundberg	Alec		1-504-491-4718					alundberg@commcaremgt.com	950 West Causeway Approach		Mandeville	LA	70471	06/16/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	CMS Casework Communication Contact	CEO	Mrs.	Psarellis	Dawn		1-225-964-8581					dpsarellis@dignityhmo.com	950 West Causeway Approach		Mandeville	LA	70471	05/08/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Coordination of Benefits Contact	PharmD	Mrs.	Pardue	Lyndsey		1-501-590-0180				1-866-870-3080	lpardue@accesshealth.services	1 Riverfront Place	Suite 515	North Little Rock	AR	72114	12/05/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Customer Service Operations Contact	CEO	Mrs.	Psarellis	Dawn	R	1-225-964-8581					dpsarellis@dignityhmo.com	950 West Causeway Approach		Mandeville	LA	70471	12/15/2020	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Government Relations Contact	CEO	Mrs.	Psarellis	Dawn		1-225-964-8581					dpsarellis@dignityhmo.com	950 West Causeway Approach		Mandeville	LA	70471	05/08/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Hospice Contact	PharmD	Mrs.	Pardue	Lyndsey		1-501-590-0180				1-866-870-3080	lpardue@accesshealth.services	1 Riverfront Place	Suite 515	North Little Rock	AR	72114	12/05/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Medicare Compliance Officer		Ms.	Corbett	Debra		1-718-964-3058					dcorbett@dignityhmo.com	950 West Causeway Approach		Mandeville	LA	70471	05/08/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Exceptions Contact	PharmD	Mrs.	Pardue	Lyndsey						1-866-870-3080	lpardue@accesshealth.services	1 Riverfront Place	Suite 515	North Little Rock	AR	72114	12/05/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active	1-501-590-0180				HMO - Health Maintenance Organization		C	Dallas
H8492	Pharmacy Network Management Contact	Director Pharmacy Network Development and Operatio		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/05/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							tconn@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/05/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active	1-833-661-1989				HMO - Health Maintenance Organization		C	Dallas
H8492	Plan to Plan Reconciliation Contact			Psarellis	Dawn		1-225-964-8581					dpsarellis@dignityhmo.com	950 West Causeway Approach		Mandeville	LA	70471	09/09/2022	2023	DIGNITY CARE CORPORATION	Local CCP	Dignity Health Plan	HMO/HMOPOS		CommCare Corporation	726	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8547	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	01/13/2020	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	01/13/2020	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Denver
H8547	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8547	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				HMO - Health Maintenance Organization		C	Denver
H8547	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Illinois	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8552	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H8552	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H8552	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Co.	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8553	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/13/2022	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H8553	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8553	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H8553	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8554	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/03/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	03/25/2019	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Denver
H8554	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8554	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				HMO - Health Maintenance Organization		C	Denver
H8554	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8564	Automated TrOOP Balance Transfer Contact		Mr.	Pendleton	Wayne		1-626-563-0588					cms-troop-balance-transfer@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	Best Available Evidence Contact		Ms.	Lan	Alice		1-626-563-0588					cms-best-available-evidence@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	Chief Financial Officer		Mr.	Su	Xing		1-626-563-0588					cms-cfo@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	CMS Casework Communication Contact		Mr.	Pendleton	Wayne		1-626-563-0588					cms-casework-communication@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	Coordination of Benefits Contact		Mr.	Pendleton	Wayne		1-626-563-0588					cms-coordination-of-benefits@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	Customer Service Operations Contact		Ms.	Lan	Alice		1-626-563-0588					cms-customer-service-operations@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	Government Relations Contact		Ms.	Lan	Alice		1-626-563-0588					cms-government-relations@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	Medicare Compliance Officer		Ms.	Lan	Alice		1-626-563-0588					cms-medicare-compliance-officer@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	Part D Exceptions Contact		Mr.	Pendleton	Wayne		1-626-563-0588					cms-part-d-exceptions@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending	1-626-563-0588				PACE - Nat		C	San Francisco
H8564	Pharmacy Network Management Contact		Mr.	Pendleton	Wayne		1-626-563-0588					cms-pharmacy-network-management@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8564	Pharmacy Technical Help Desk Contact		Mr.	Pendleton	Wayne		1-626-563-0588					cms-pharmacy-technical-help-desk@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending	1-626-563-0588				PACE - Nat		C	San Francisco
H8564	Plan to Plan Reconciliation Contact		Mr.	Pendleton	Wayne		1-626-563-0588					cms-plan-to-plan-reconciliation@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/28/2022	2023	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8578	Automated TrOOP Balance Transfer Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		1-413-233-3423				1-413-233-3423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	01/01/2020	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Best Available Evidence Contact	Medicare Program Manager	Ms.	Sepko	Amy		1-413-787-4000	3351			1-413-233-3351	asepko@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	03/13/2017	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Chief Financial Officer	Chief Financial Officer	Ms.	Cohen	Lisa		1-413-233-3024					lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	08/26/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	CMS Casework Communication Contact	Complaints & Appeals Manager	Mr.	Farrell	James		1-413-233-3231				1-413-233-3231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	03/01/2018	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Coordination of Benefits Contact	Claims Analytics & Payment Policy Manager	Ms.	Shaw	Joanne		1-413-233-3444				1-413-233-3444	jshaw@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	03/13/2017	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Customer Service Operations Contact	Manager Member Services	Ms.	Armstrong	Carolyn		1-413-233-3301				1-413-233-3301	carmstrong@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	02/17/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Government Relations Contact	Medicare Program Manager	Ms.	Sepko	Amy		1-413-787-4000	3351			1-413-233-3351	asepko@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/06/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Hospice Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		1-413-233-3423				1-413-233-3423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	03/01/2018	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Medicare Compliance Officer	Director of Compliance	Ms	Tulloch	Charmalee		1-413-233-3566				1-413-233-3566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/27/2022	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Part D Exceptions Contact	Manager, Prior Authorization		Mourad	Hala							hala.mourad@optum.com	2441 Warrenville Rd	Suite 400	Lisle	IL	60532	01/01/2020	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	1-630-328-5837				HMO - Health Maintenance Organization		C	New York
H8578	Pharmacy Network Management Contact			Pham	Katie		1-817-846-9722					katie.pham@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/01/2020	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8578	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Summers	Todd							todd.summers@optum.com	755 Research Parkway	Suite 300	Oklahoma City	OK	73104	01/01/2020	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	1-866-443-1095				HMO - Health Maintenance Organization		C	New York
H8578	Plan to Plan Reconciliation Contact	Assistant Controller	Ms.	King	Katie		1-413-787-4000	3008				kking2@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	05/13/2020	2023	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8597	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	07/10/2020	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	05/29/2020	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/15/2020	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	12/16/2022	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-707-5698				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	05/05/2020	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	12/19/2022	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H8597	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8597	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H8597	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	11/30/2022	2023	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8604	Automated TrOOP Balance Transfer Contact	Clinical Pharmacist		Hill	Brendal		1-865-256-5940				1-304-885-7592	bhill@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/25/2022	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Best Available Evidence Contact	Manager Medicare Operations		Panas	Lori		1-740-699-6208				1-740-699-6164	lorip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	01/10/2018	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Chief Financial Officer	Chief Financial Officer	Mr	Ralston	Ryan		1-740-699-6236				1-740-699-6161	rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/13/2019	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	CMS Casework Communication Contact	Director Medicare Operations		Richard	Penny		1-740-695-7597				1-740-699-6163	PennyR@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/18/2021	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Coordination of Benefits Contact	Manager COB		Fetty	Jackie		1-740-695-7699				1-740-699-6163	jfetty@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/06/2019	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Customer Service Operations Contact	Director Medicare Operations		Richard	Penny		1-740-695-7597				1-740-699-6163	PennyR@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/18/2021	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Government Relations Contact	Gov''t Compliance Officer	Ms	Medley	Jill		1-740-695-7693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/18/2021	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Hospice Contact	Manager, Pharmacy Compliance		Johnson	Chasity		1-740-359-8592				1-304-885-7592	ChasityJ@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	04/27/2021	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Medicare Compliance Officer	Gov''t Compliance Officer	Ms	Medley	Jill		1-740-695-7693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/18/2021	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Part D Exceptions Contact	Clinical Pharmacist		Hill	Brendal						1-304-885-7592	bhill@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/25/2022	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active	1-800-624-6961	6627			PPO - BBA		C	Philadelphia
H8604	Pharmacy Network Management Contact	Network Account Dir, Retail Strategy & Contracting		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	10/19/2016	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8604	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	Express Scripts	13051 N. Telecom PKWY STE 150	Temple Terrace	FL	33637	11/18/2021	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active	1-800-922-1557				PPO - BBA		C	Philadelphia
H8604	Plan to Plan Reconciliation Contact	Controller		Marsh	Jane		1-740-699-6121				1-740-699-6161	jmarsh@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/30/2018	2023	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Philadelphia
H8614	Automated TrOOP Balance Transfer Contact	Business Office Manager		Kasprzewski	Brenda		1-302-865-3565	104				bkasprzewski@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	11/09/2021	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Best Available Evidence Contact	Business Office Manager		Kasprzewski	Brenda		1-302-865-3565	104				bkasprzewski@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	11/09/2021	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Chief Financial Officer	CFO	Mr.	Braun	Sheldon		1-732-262-2255				1-732-276-9866	Sbraun@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	10/10/2021	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	CMS Casework Communication Contact	Marketing Director		Steele	Erin		1-302-865-3565	101				esteele@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	11/09/2021	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Coordination of Benefits Contact	Business Office Manager		Kasprzewski	Brenda		1-302-865-3565	104				bkasprzewski@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	11/09/2021	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Customer Service Operations Contact	Director Information Technology	Mr	Forman	Joe		1-732-262-2255	2120			1-732-276-9866	jforman@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	06/22/2020	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Government Relations Contact	Officer	Mr	Halberstam	Yitzchock		1-732-642-9142				1-732-276-9866	Yhalberstam@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	06/22/2020	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Medicare Compliance Officer	Director of Quality, Compliance, & Education	Ms.	Schindler	Colleen		1-302-865-3565	108			1-732-276-9866	cschindler@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	10/13/2022	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part D Exceptions Contact	Business Office Manager		Kasprzewski	Brenda						1-732-276-9866	bkasprzewski@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	11/10/2021	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active	1-833-722-3302				PACE - Nat		C	Philadelphia
H8614	Pharmacy Network Management Contact	Controller		Friedman	Ben		1-732-262-2255	2106			1-732-276-9866	bfriedman@nationwidehealthcare.com	260 Chambers Ridge Road		Brick	NJ	08723	06/22/2020	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Pharmacy Technical Help Desk Contact	Business Office Manager		Kasprzewski	Brenda						1-732-276-9866	bkasprzewski@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	11/10/2021	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active	1-833-722-3302				PACE - Nat		C	Philadelphia
H8614	Plan to Plan Reconciliation Contact	Business Office Manager		Kasprzewski	Brenda		1-302-865-3565	104				bkasprzewski@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	11/10/2021	2023	MILFORD WELLNESS VILLAGE PACE	National PACE	Milford Wellness Village PACE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8634	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				PPO - BBA		C	Denver
H8634	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8634	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				PPO - BBA		C	Denver
H8634	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Denver
H8649	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/15/2020	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/23/2022	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-602-618-3945				HMO - Health Maintenance Organization		C	Philadelphia
H8649	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8649	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	1-800-238-6279				HMO - Health Maintenance Organization		C	Philadelphia
H8649	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/23/2022	2023	AETNA HEALTH OF UTAH INC	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8655	Automated TrOOP Balance Transfer Contact	Director, PACE Finance	Ms	Hewitt	Jessica		1-720-974-6767	0			1-303-996-1600	jhewitt@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	09/29/2021	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-303-869-4664				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/17/2021	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	Chief Financial Officer	CFO	Ms.	Gutierrez	Barbara		1-303-869-4664	0			1-303-996-1600	bgutierrez@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	10/04/2018	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-804-543-0876				1-303-996-1600	epeak@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	10/01/2021	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-303-869-4664	0				lbrown2@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/09/2020	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	Customer Service Operations Contact	COO	Ms	Boswell	Silvia		1-215-951-4433					sboswell@myinnovage.com	6970 Germantown Ave		Philadelphia	PA	19119	09/29/2021	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	Government Relations Contact	Executive VP Government Relations		Steckel	Carol		1-720-789-6157				1-303-996-1600	CSteckel@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/26/2022	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	Medicare Compliance Officer	VP of Pharmacy Services	Mrs	Chase	Darla		1-720-974-6785				1-303-996-1600	dchase@myinnovage.com	8950 East Lowry Blvd		Denvere	CO	80203	04/24/2020	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	Part D Exceptions Contact	VP of Pharmacy Services	Ms	Chase	Darla							dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Philadelphia
H8655	Pharmacy Network Management Contact	VP of Pharmacy Services	Ms	Chase	Darla		1-720-974-6785					dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8655	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Ms	Chase	Darla							dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Philadelphia
H8655	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-303-869-4664	0			1-720-917-3390	AKizewski@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	09/29/2021	2023	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H8711	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H8711	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8711	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H8711	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H8748	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				HMO - Health Maintenance Organization		C	San Francisco
H8748	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8748	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/04/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				HMO - Health Maintenance Organization		C	San Francisco
H8748	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		1-858-790-6250					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/01/2020	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Best Available Evidence Contact	Supervisor Medicare Membership Accounting	Ms.	Saucedo	Sonya		1-503-584-4236				1-503-584-4234	Sonya.saucedo@phtech.com	3990 Fairview Industrial Drive SE		Salem	OR	97302	02/28/2022	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Chief Financial Officer	Chief Financial Officer	Mr.	Morgan	Matthew		1-831-625-4965				1-831-624-7130	matthew.morgan@aspirehealthplan.org	23625 Holman Highway		Monterey	CA	93940	02/15/2013	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	CMS Casework Communication Contact	Appeals and Grievances Analyst	Ms.	Pummell	Stef		1-831-644-7432				1-831-657-0703	stef.pummell@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	06/13/2017	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Coordination of Benefits Contact	Supervisor Medicaid Membership Accounting	Ms.	Wilson	Jennifer		1-503-362-2818	1251			1-503-584-4234	jennifer.wilson@phtech.com	3990 Fairview Industrial Drive SE		Salem	OR	97302	02/28/2022	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Customer Service Operations Contact	Chief Sales & Marketing Officer	Ms.	O'Brien	Cynthia		1-831-644-7406					Cynthia.OBrien@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	01/01/2020	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Government Relations Contact	Vice President, Medicare Operations	Ms.	Hall	Melissa		1-831-644-7415				1-831-657-0703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Hospice Contact	Vice President, Medicare Operations	Ms.	Hall	Melissa		1-831-644-7415				1-831-657-0703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Medicare Compliance Officer	Compliance Officer	Mr.	Serrano	Anthony		1-831-644-7409				1-831-657-0703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Part D Exceptions Contact	Dir PA & UM Programs		Emoto	Julianne							Julianne.emoto@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/01/2020	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active	1-858-790-5846				HMO - Health Maintenance Organization		C	San Francisco
H8764	Pharmacy Network Management Contact	Director Configuration Services		Moe	Kathleen		1-858-790-7437					kathlene.moe@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/23/2020	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8764	Pharmacy Technical Help Desk Contact	VP, Contact Center Services		Battle	Dorry							Customerservice@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/01/2020	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active	1-888-495-3160				HMO - Health Maintenance Organization		C	San Francisco
H8764	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Morgan	Matthew		1-831-625-4965				1-831-624-7130	matthew.morgan@aspirehealthplan.org	23625 Holman Highway		Monterey	CA	93940	04/15/2015	2023	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8768	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				PPO - BBA		C	San Francisco
H8768	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8768	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				PPO - BBA		C	San Francisco
H8768	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	San Francisco
H8769	Automated TrOOP Balance Transfer Contact	Senior Director of Finance PACE	Mr.	Vieu	Geoge		1-708-478-7943				1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	10/21/2020	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	Best Available Evidence Contact	Medical Director	Dr.	Dudley	Morgan		1-810-236-7471				1-810-236-7558	morgan.dudley@ascension.org	412 E First Street		Flint	MI	48502	04/01/2021	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	Chief Financial Officer	Senior Director of Finance, PACE	Mr.	Vieu	George		1-708-478-7943					george.vieu@ascension.org	18927 Hickory Creek Drive	Suite 300	Mokena	IL	60448	05/24/2019	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	CMS Casework Communication Contact	Director of Quality	Ms.	Fierke	Christina		1-810-236-7472				1-810-236-7558	christina.fierke@ascension.org	412 E First Street		Flint	MI	48502	11/05/2020	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	Coordination of Benefits Contact	Senior Director of Finance PACE	Mr.	Vieu	Geoge		1-708-478-7943				1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	10/21/2020	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	Customer Service Operations Contact	Executive Director	Mr.	Berry	Craig		1-810-236-7500				1-810-236-7558	craig.berry@ascension.org	412 E First Street		Flint	MI	48502	04/01/2021	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	Government Relations Contact	Executive Director	Mr.	Berry	Craig		1-810-236-7500				1-810-236-7558	craig.berry@ascension.org	412 E First Street		Flint	MI	48502	04/01/2021	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	Medicare Compliance Officer	Director of Quality	Ms.	Fierke	Christina		1-810-236-7472				1-810-236-7558	christina.fierke@ascension.org	412 E First Street		Flint	MI	48502	11/05/2020	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	Part D Exceptions Contact	Senior Director of Finance PACE	Mr.	Vieu	George						1-423-622-6048	george.vieu@ascension.org	250 East 10th Street		Chattanooga	TN	37402	10/21/2020	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active	1-800-441-8883				PACE - Nat		C	Chicago
H8769	Pharmacy Network Management Contact	Medical Director	Dr.	Dudley	Morgan		1-810-236-7471				1-810-236-7558	morgan.dudley@ascension.org	412 E First Street		Flint	MI	48502	04/01/2021	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8769	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Dudley	Morgan						1-810-236-7558	morgan.dudley@ascension.org	412 E First Street		Flint	MI	48502	04/01/2021	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active	1-810-236-7500				PACE - Nat		C	Chicago
H8769	Plan to Plan Reconciliation Contact	Claims Manager	Mr.	Stengele	Brett		1-815-529-1077				1-423-622-6048	brett.stengele@ascension.org	250 East 10th Street		Chattanooga	TN	37402	03/14/2022	2023	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Chicago
H8777	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Dafoe	Kevin		1-716-285-8224	220				Dafoe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	02/19/2013	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	Best Available Evidence Contact	Chief Executive Officer	Mr	Kinner	John		1-716-285-8224	147				kinner@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/22/2013	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	Chief Financial Officer	Chief Financial Officer	Mr	Dafoe	Kevin		1-716-285-8224	220				Dafoe@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/19/2013	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	CMS Casework Communication Contact	Clinical Manager		Hall	Bryan		1-716-285-8248					hall@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	12/04/2019	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	Coordination of Benefits Contact	Chief Financial Officer		Dafoe	Kevin		1-716-285-8224	220				Dafoe@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/19/2013	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	Customer Service Operations Contact	Chief Executive Officer	Mr	Kinner	John		1-716-285-8224	147				kinner@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/03/2014	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	Government Relations Contact	Chief Executive Officer	Mr	Kinner	John		1-716-285-8224	147				kinner@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/22/2013	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	Medicare Compliance Officer	Chief Executive Officer	Mr	Kinner	John		1-716-285-8224	147				kinner@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/03/2014	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	Part D Exceptions Contact	Chief Executive Officer	Mr	Kinner	John							kinner@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/03/2014	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active	1-800-303-4333				PACE - Nat		C	New York
H8777	Pharmacy Network Management Contact	Chief Executive Officer	Mr	Kinner	John		1-716-285-8224	147				kinner@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/03/2014	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8777	Pharmacy Technical Help Desk Contact	Chief Financial Officer		Dafoe	Kevin							Dafoe@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/19/2013	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active	1-888-303-4333	220			PACE - Nat		C	New York
H8777	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dafoe	Kevin		1-716-285-8224	220				Dafoe@hanci.com	1302 Main Street		Niagara Falls	NY	14301	02/19/2013	2023	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active					PACE - Nat		C	New York
H8783	Automated TrOOP Balance Transfer Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	10/25/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Best Available Evidence Contact	Medicare Enrollment Supervisor		Johnson	Michael		1-612-676-7220					mjohnson4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	10/25/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Chief Financial Officer	SVP and Chief Financial Officer	Ms.	Monsrud	Beth		1-612-676-3217				1-612-676-6501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/09/2018	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	CMS Casework Communication Contact	A&G Regulatory and Compliance Specialist		Wood	Nakia		1-612-294-5668					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Coordination of Benefits Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Customer Service Operations Contact	CS Support Services Sr Manager		Vang	Pakou		1-612-676-3585					pvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Government Relations Contact	Federal Government Relations Specialist		Vang	Julie		1-612-294-5654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/30/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Hospice Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051					pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	McMahon	Jane		1-612-456-7817					federalgrleadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	07/27/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Part D Exceptions Contact	Vice President Pharmacy Management		Mitsch	Patrick						1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active	1-612-294-5051				PPO - BBA		C	Chicago
H8783	Pharmacy Network Management Contact	Vice President Pharmacy Management		Mitsch	Patrick		1-612-294-5051				1-612-884-2263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8783	Pharmacy Technical Help Desk Contact	Director, Customer Service		Warren	Mark							mwarren@express-scripts.com	6625 West 78th Street		Minneapolis	MN	55439	11/30/2020	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H8783	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		1-612-676-3213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/09/2018	2023	UCARE HEALTH, INC.	Local CCP	UCare	Local PPO		UCare Minnesota	238	Yes	Active					PPO - BBA		C	Chicago
H8786	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Best Available Evidence Contact	Manager II Enrollment Data		Young	Carrie		1-757-323-1029					carrie.young@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/17/2022	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				Demo Risk Option C	MMP HMO Demo	C	Dallas
H8786	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	AMERIGROUP TEXAS, INC.	Demo	Amerigroup STAR+PLUS MMP	Medicare-Medicaid Plan HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Dallas
H8797	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/17/2020	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/17/2020	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/17/2020	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/15/2021	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Medicare Compliance Officer	Compliance Officer	Mrs.	Olesky	Lisa		1-513-275-7952					lisa.olesky@perennialadvantage.com	9200 Worthington Road	Suite 110	Westerville	OH	43082	06/07/2022	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/15/2021	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Chicago
H8797	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/15/2021	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/17/2020	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Chicago
H8797	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8800	Automated TrOOP Balance Transfer Contact	Accounting Manager	Mrs.	Johnson	Stephanie		1-716-379-8474				1-716-379-8543	sjohnson@homecare-hospice.org	519 North Union Street		Olean	NY	14760	04/22/2020	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	Best Available Evidence Contact	Chief Executive Officer	Ms.	Sullivan	Melissa		1-716-372-2106					msullivan@homecare-hospice.org	1225 West State Street		Olean	NY	14760-2135	01/31/2022	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	Chief Financial Officer	Chief Financial Officer	Ms	Nelson	Susan	A	1-716-372-2106					snelson@homecare-hospice.org	1225 West State Street		Olean	NY	14760-2135	06/16/2008	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	CMS Casework Communication Contact	QI Manager	Ms	Gibble	Roberta		1-716-379-8474					rgibblel@totalseniorcare.org	1225 West State Street		Olean	NY	14760-2135	01/16/2020	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	Coordination of Benefits Contact	Accounting Manager	Mrs.	Johnson	Stephanie		1-716-379-8474				1-716-379-8543	sjohnson@homecare-hospice.org	519 North Union Street		Olean	NY	14760	04/22/2020	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	Customer Service Operations Contact	Executive Program Director	Mrs	Padlo	Roxanne		1-716-379-8474					rpadlo@totalseniorcare.org	519 North Union Street		Olean	NY	14760-2135	01/31/2022	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	Government Relations Contact	Chief Executive Officer	Ms	Sullivan	Melissa		1-716-372-2106					msullivan@homecare-hospice.org	1225 West State Street		Olean	NY	14760-2135	01/31/2022	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	Medicare Compliance Officer	Executive Program Director	Mrs	Padlo	Roxanne		1-716-379-8474					rpadlo@totalseniorcare.org	519 North Union Street		Olean	NY	14760-2135	10/21/2020	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	Part D Exceptions Contact	Chief Financial Officer	Ms	Nelson	Susan	A						snelson@homecare-hospice.org	1225 West State Street		Olean	NY	14760-2135	12/16/2008	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active	1-716-719-7129				PACE - Nat		C	New York
H8800	Pharmacy Network Management Contact	Chief Financial Officer	Ms	Nelson	Susan		1-716-372-2106					snelson@homecare-hospice.org	1225 West State Street		Olean	NY	14760-2135	11/10/2021	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8800	Pharmacy Technical Help Desk Contact	Health Information Systems Manager	Mr.	Pavlock	Lawrence							lpavlock@homecare-hospice.org	1225 West State Street		Olean	NY	14760-2135	11/10/2021	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active	1-800-719-7129				PACE - Nat		C	New York
H8800	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms	Nelson	Susan	A	1-716-372-2106					snelson@homecare-hospice.org	1225 West State Street		Olean	NY	14760-2135	12/16/2008	2023	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active					PACE - Nat		C	New York
H8845	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/14/2021	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H8845	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8845	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H8845	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8849	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H8849	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H8849	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	AMERIGROUP INSURANCE COMPANY	Local CCP	Amerigroup	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8854	Automated TrOOP Balance Transfer Contact	Part D Business Analyst	Ms	Ellerbee	Ashley		1-410-998-4314					Ashley.Ellerbee@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	11/10/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Best Available Evidence Contact	Manager, Enrollment	Ms.	Knox	Dorothea		1-410-998-5559					Dorothea.Knox@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	07/28/2022	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Chief Financial Officer	Interim CFO/Dir, Financial Plng & Analysis	Mr.	Crippen	Ryan		1-410-998-5459					Ryan.Crippen@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/17/2022	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	CMS Casework Communication Contact	Director, Health Services	Ms.	Baumhardt-Rivera	Cindy		1-410-605-2508					Cindy.Baumhardt-Rivera@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	11/10/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Coordination of Benefits Contact	Part D Business Analyst	Ms	Ellerbee	Ashley		1-410-998-4314					Ashley.Ellerbee@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	11/10/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Customer Service Operations Contact	Manager, Member Services	Ms.	Boer	Kelsey		1-410-998-5359					Kelsey.Boer@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	07/23/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Government Relations Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		1-410-605-2579					mary-paul.snapp-borleis@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	10/10/2020	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Hospice Contact	Director, Health Services	Ms	Baumhardt-Rivera	Cindy		1-410-605-2508					Cindy.Baumhardt-Rivera@carefirst.com	P.O. Box 915		Owing Mills	MD	21117	11/10/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		1-410-605-2579					mary-paul.snapp-borleis@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	10/10/2020	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Part D Exceptions Contact	Part D Business Analyst	Ms	Ellerbee	Ashley							Ashley.Ellerbee@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	11/10/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	1-855-344-0930				HMO - Health Maintenance Organization		C	Philadelphia
H8854	Pharmacy Network Management Contact	Directory, Pharmacy Government Programs	Mr.	Nardone	Mark		1-410-998-5675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/23/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8854	Pharmacy Technical Help Desk Contact	Director, Pharmacy Government Programs	Mr.	Nardone	Mark							Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/23/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Philadelphia
H8854	Plan to Plan Reconciliation Contact	Director, Financial Planning	Mr.	Crippen	Ryan		1-410-998-5459					Ryan.Crippen@carefirst.com	P.O. Box 782437		Philadelphia	PA	19178-2437	12/03/2021	2023	CareFirst Advantage DSNP, Inc.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H8889	Automated TrOOP Balance Transfer Contact			Bean	Danielle		1-952-992-2864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Best Available Evidence Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Chief Financial Officer		Ms	Quist	Mary		1-952-992-2058					mary.quist@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	CMS Casework Communication Contact			Sikorski	TJ		1-952-992-8542				1-952-992-8492	thomas.sikorski@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/04/2023	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Coordination of Benefits Contact			Vilendrer	Krista		1-952-992-3252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Customer Service Operations Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Government Relations Contact			Kinsella	Ann		1-952-992-3832					ann.kinsella@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/21/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Hospice Contact			Bourdages	Kathy		1-952-992-3653				1-952-992-3636	PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/13/2018	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Medicare Compliance Officer		Mrs	Koranteng	Milly		1-952-992-2090					mildred.koranteng@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/22/2020	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/25/2018	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	1-952-992-2353				PPO - BBA		C	Kansas City
H8889	Pharmacy Network Management Contact			Dornbrook-Lavender	Kimberly		1-952-992-3448					kimberly.dornbrook-lavender@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8889	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	La Tasha							LaTasha_Monroe@expressscripts.com	13051 N. Telecom Pkwy		Temple Terrace	FL	33637	11/17/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	1-800-922-1557				PPO - BBA		C	Kansas City
H8889	Plan to Plan Reconciliation Contact			Cameron	Andrew		1-952-992-2386					Andrew.Cameron@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	11/12/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Kansas City
H8894	Automated TrOOP Balance Transfer Contact	Senior Director Pharmaceutical Services		Jai	Edward		1-909-727-5304				1-951-891-1577	jai-e@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/05/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Best Available Evidence Contact	Manager, Eligibility and Member Configuration		Ramirez	Tiana		1-909-890-2073					ramirez-t@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/05/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Keenan		1-909-890-2130				1-909-890-2019	freeman-k2@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/05/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	CMS Casework Communication Contact	Manager, Grievance & Appeals Clinical		Wellmaker	Jennifer		1-909-890-2701				1-909-890-5748	wellmaker-j@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/12/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Coordination of Benefits Contact	Senior Director Pharmaceutical Services		Jai	Edward		1-909-727-5304				1-951-891-1577	jai-e@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/12/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Customer Service Operations Contact	Director Member Services Call Management		Zamudio	Olivia		1-951-374-3235				1-909-890-5877	zamudio-o@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/12/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Government Relations Contact	Chief Executive Officer	Mr	McNaughton	Jarrod		1-909-890-2010				1-909-890-2973	mcnaughton-jb@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Hospice Contact	Clinical Pharmacy Program & Formulary	Dr.	Blatt	Michael		1-909-256-0753				1-951-891-1577	blatt-m@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Medicare Compliance Officer	Manager Regulatory Affairs Medicare	Mr	Haines	Randy		1-909-296-0251					haines-r@iehp.org	10801 Sixth St		Rancho Cucamonga, CA 91730	CA	91730	01/03/2023	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Part D Exceptions Contact	Senior Director Pharmaceutical Services	Dr.	Jai	Edward						1-951-891-1577	jai-e@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active	1-909-727-5304				HMO - Health Maintenance Organization		C	San Francisco
H8894	Pharmacy Network Management Contact	Senior Director Pharmaceutical Services	Dr.	Jai	Edward		1-909-727-5304				1-951-891-1577	jai-e@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8894	Pharmacy Technical Help Desk Contact	Director, Contact Center Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	11/29/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active	1-888-495-3147				HMO - Health Maintenance Organization		C	San Francisco
H8894	Plan to Plan Reconciliation Contact	Senior Director Pharmaceutical Services	Dr.	Jai	Edward		1-909-727-5304				1-951-891-1577	jai-e@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2023	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations and Formulary	Ms.	Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/09/2022	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Best Available Evidence Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		1-562-637-1234				1-562-989-5243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/09/2022	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Chief Financial Officer	Chief Financial Officer	Mr.	Plumb	Michael		1-562-997-1589					MPlumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/10/2022	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	CMS Casework Communication Contact	Director, Reg Audit & Ent Mntrng		Cordova	Elizabeth		1-562-997-3131	3131			1-562-989-5120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/19/2022	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Coordination of Benefits Contact	Director, Pharmacy Operations and Formulary	Ms.	Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/03/2022	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		1-562-997-1805				1-562-989-5181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Government Relations Contact	Sr. Vice President, Public & Government Affairs		Morrell	Adrienne		1-202-349-9008				1-562-989-9439	amorrell@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Hospice Contact	Manager, Pharmacy Experience & Access	Mr.	Tran	Tri		1-562-308-2884				1-562-997-3196	TMTran@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	02/09/2022	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Medicare Compliance Officer	Compliance Officer	Ms.	Hawkins	Ginette		1-562-308-1195					GHawkins@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Part D Exceptions Contact	Senior Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/17/2021	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	San Francisco
H8902	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/17/2021	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8902	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy	STE 150	Temple Terrace	FL	33637	12/17/2021	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	San Francisco
H8902	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		1-562-989-8300				1-562-989-0101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2023	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H8908	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-502-580-9138				HMO - Health Maintenance Organization		C	Kansas City
H8908	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	1-800-865-8715				HMO - Health Maintenance Organization		C	Kansas City
H8908	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8928	Automated TrOOP Balance Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		1-800-333-2535	79089				Christina.Farrar@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Best Available Evidence Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		1-800-333-2535	79089				Christina.Farrar@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Chief Financial Officer	Chief Financial Officer	Mr.	Bailey	Todd		1-508-368-9097				1-508-791-4332	Todd.Bailey@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	CMS Casework Communication Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		1-508-799-2100	79275				Heather.Ulfves@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Coordination of Benefits Contact	Senior Director, Claims Administration	Ms	Straitiff	Kirsten		1-508-368-9047					kirsten.straitiff@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	09/20/2022	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Customer Service Operations Contact	VP, Customer Service	Mr.	Perron	Donald		1-508-368-9701					Donald.Perron@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Government Relations Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		1-508-368-9539					Lisa.Lashbrook@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Hospice Contact	Supervisor, Pharmacy Technician Team	Ms.	Kendall	Kate		1-800-333-2535	79169				Kate.Kendall@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Medicare Compliance Officer	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		1-508-368-9539					Lisa.Lashbrook@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Part D Exceptions Contact	Manager, Pharmacy Ops & Clinical Programs	Mr.	Sartini	David							David.Sartini@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	02/17/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	1-508-368-9790				HMO - Health Maintenance Organization		C	Boston
H8928	Pharmacy Network Management Contact	VP, Pharmacy Services	Mr.	Barner	Benjamin		1-508-368-9660					Benjamin.Barner@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	09/19/2022	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8928	Pharmacy Technical Help Desk Contact			Help Desk	OptumRx								1600 McConnor Parkway		Schaumburg	IL	60173	12/29/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	1-844-368-8734				HMO - Health Maintenance Organization		C	Boston
H8928	Plan to Plan Reconciliation Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		1-508-368-9085					Shawn.McNamara@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/14/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8934	Automated TrOOP Balance Transfer Contact	Pace, Director of finance & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	Best Available Evidence Contact	Pace, Director of Finance & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					Estenieau.jean@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	Chief Financial Officer	Pace, Director of Finance & Compliance	Mr	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	CMS Casework Communication Contact	Pace, Finance Director & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	3201-A Tioga  Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	Coordination of Benefits Contact	Pace Finance Director& Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	Customer Service Operations Contact	Executive Director	Mr.	Reiter	Thomas		1-724-448-4129					tom@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	Government Relations Contact	Executive Director	Mr	Reiter	Thomas		1-202-810-2247					tom@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	Medicare Compliance Officer	Quality Improvement Director	Mr.	Jean	Estenieau		1-703-587-4858					estenieau.jean@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	Part D Exceptions Contact	Pace, Director of Finance & Compliance	Mr.	Jean	Estenieau							estenieau.jean@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending	1-000-000-0000				PACE - Nat		C	Philadelphia
H8934	Pharmacy Network Management Contact	Pace, Director of Finance & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8934	Pharmacy Technical Help Desk Contact		Mr.	Jean	Estenieau								3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending	1-000-000-0000				PACE - Nat		C	Philadelphia
H8934	Plan to Plan Reconciliation Contact	Pace, Director of Finance & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/14/2022	2023	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	West Baltimore Pace Community Coalition	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H8961	Automated TrOOP Balance Transfer Contact	Medicare Pharmacy Program Manager		Freking	Alicia		1-917-502-8368					afreking@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	06/30/2020	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Best Available Evidence Contact	Senior Director, Insurance Operations		Fierro Randazzo	Michael		1-224-342-7889					mfierrorandazzo@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	08/08/2021	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Chief Financial Officer	Chief Financial Officer	Mr	Blackley	Scott		1-202-421-9368					blackley@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	04/26/2021	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	CMS Casework Communication Contact	Grievance and Appeal Lead		Bella	Frankie		1-602-380-3902					frankie@hioscar.com	615 S. River Drive		Tempe	AZ	85281	06/29/2022	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Coordination of Benefits Contact	Associate Director of Insurance Operations		Avon	Nicholas		1-812-204-7309					navon@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	06/30/2020	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Customer Service Operations Contact	Director Concierge Medicare Advantage		Riley	John		1-401-654-1223					jriley@hioscar.com	615 S. River Drive		Tempe	AZ	85281	01/20/2022	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Government Relations Contact	Director, Government Affairs		Canter	Alyssa		1-917-710-0091					acanter@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	08/08/2021	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Hospice Contact	Medicare Pharmacy Program Manager		Freking	Alicia		1-917-502-8368					afreking@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	06/30/2020	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Medicare Compliance Officer	Director, Medicare Compliance	Mrs.	Jaikaran	Nandini		1-917-653-2676					njaikaran@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	05/26/2022	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Part D Exceptions Contact	Medicare Pharmacy Program Manager		Freking	Alicia							afreking@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	06/30/2020	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active	1-855-672-2720				HMO - Health Maintenance Organization		C	New York
H8961	Pharmacy Network Management Contact	Medicare Pharmacy Program Manager		Freking	Alicia		1-917-502-8368					afreking@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	06/30/2020	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8961	Pharmacy Technical Help Desk Contact	Medicare Pharmacy Program Manager		Freking	Alicia							afreking@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	06/30/2020	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H8961	Plan to Plan Reconciliation Contact	Financial Reporting Manager		Yang	Elaine		1-646-770-0382					elaine@hioscar.com	75 Varick St	5th Floor	New York	NY	10013	02/11/2020	2023	OSCAR MANAGED CARE OF SOUTH FLORIDA, INC	Local CCP	Oscar	HMO/HMOPOS		Oscar Health, Inc.	731	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8967	Automated TrOOP Balance Transfer Contact	Senior Director of Government Programs	Ms.	Fuller	Rebecca		1-605-328-7007					rebecca.fuller@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Best Available Evidence Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Chief Financial Officer	Vice President of Finance	Mr.	Maude	Brian		1-605-328-6801					Brian.Maude@SanfordHealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	CMS Casework Communication Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		1-605-328-7182					aleesa.jansick@sanfordhealth.org	300 Cherapa place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Coordination of Benefits Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		1-605-312-2624					daniel.reichelt@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Customer Service Operations Contact	Director of Customer Service	Mr.	Ling	Ryan		1-605-312-7459					ryan.ling@sanfordhealth.org	300 N Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Government Relations Contact	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Hospice Contact	Director of Utilization Management	Ms.	Kanta	Misty		1-605-312-2788					misty.kanta@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		1-605-328-6806					dallan.yeoman@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Exceptions Contact	Manager, Prior Authorization	Ms.	Le	Christina						1-877-239-4565	rxsol_prior_auth_redirected_queue_DL@uhc.com	3515 Harbor Blvd		Costa Mesa	CA	92626	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	1-888-403-3398				HMO - Health Maintenance Organization		C	Dallas
H8967	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway	Suite 200	Schaumburg	IL	60173-6801	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	1-844-642-9090				HMO - Health Maintenance Organization		C	Dallas
H8967	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		1-605-312-9344					debora.harris@sanfordhealth.org	300 Cherapa Place	Suite 201	Sioux Falls	SD	57103	01/04/2023	2023	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8982	Automated TrOOP Balance Transfer Contact	Business Office Manager		Lewars	Olga		1-305-751-8626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/29/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	Best Available Evidence Contact	AVP PACE		Lane	Maria		1-305-751-8626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/29/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	Chief Financial Officer	CFO	Mr.	Durr	Michael		1-305-751-8626	63298				MDurr@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	CMS Casework Communication Contact	QAPI Manager		Orozco	Andrew		1-305-751-8626	66754				borozco@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	Coordination of Benefits Contact	AVP PACE		Lane	Maria		1-305-751-8626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	Customer Service Operations Contact	AVP PACE	Mr.	Lane	Maria		1-305-751-8626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	Government Relations Contact	AVP PACE		Lane	Maria		1-305-751-8626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	Medicare Compliance Officer	AVP PACE	Ms.	Lane	Maria		1-305-751-8626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	Part D Exceptions Contact	Business Office Manager		Lewars	Olga						1-305-795-1855	olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending	1-305-751-8626	66299			PACE - Nat		C	Atlanta
H8982	Pharmacy Network Management Contact	Director of Pharmacy		Martinez	Mario		1-305-751-8626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8982	Pharmacy Technical Help Desk Contact	Director of Pharmacy		Martinez	Mario						1-305-795-1855	MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending	1-305-751-8626	66299			PACE - Nat		C	Atlanta
H8982	Plan to Plan Reconciliation Contact	Business Office Manager		Lewars	Olga		1-305-751-8626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2023	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8998	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		1-614-546-3183				1-614-546-3131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		1-614-546-3222				1-614-546-3148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		1-614-546-3211				1-614-546-3131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	CMS Casework Communication Contact	Compliance Specialist	Mr.	Jordan	David	A	1-614-706-8474				1-614-234-8372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Customer Service Operations Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		1-614-546-3180				1-614-546-3132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Government Relations Contact	CEO	Mr	Randolph	John	C	1-614-546-3152				1-614-546-3131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		1-412-478-0244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Part D Exceptions Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active	1-800-240-3851				PPO - BBA		C	Chicago
H8998	Pharmacy Network Management Contact	Director, Pharmacy	Mr	Turoff	Chris		1-614-403-0394					chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H8998	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active	1-866-693-4620				PPO - BBA		C	Chicago
H8998	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC	Local CCP	Trinity Health Plan Of New England	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H9001	Automated TrOOP Balance Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		1-800-333-2535	79089				Christina.Farrar@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/24/2019	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Best Available Evidence Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		1-800-333-2535	79089				Christina.Farrar@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	04/24/2019	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Chief Financial Officer	Chief Financial Officer	Mr.	Bailey	Todd		1-508-368-9097				1-508-791-4332	Todd.Bailey@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	08/27/2019	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	CMS Casework Communication Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		1-508-799-2100	79275				Heather.Ulfves@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	08/09/2018	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Coordination of Benefits Contact	Senior Director, Claims Administration	Ms	Straitiff	Kirsten		1-508-368-9047					kirsten.straitiff@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	09/20/2022	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Customer Service Operations Contact	VP, Customer Service	Mr.	Perron	Donald		1-508-368-9701					Donald.Perron@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	12/01/2015	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Government Relations Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		1-508-368-9539					Lisa.Lashbrook@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	12/01/2015	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Hospice Contact	Supervisor, Pharmacy Technician Team	Ms.	Kendall	Kate		1-800-333-2535	79169				Kate.Kendall@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/31/2018	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Medicare Compliance Officer	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		1-508-368-9539					Lisa.Lashbrook@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	12/01/2015	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Part D Exceptions Contact	Manager, Pharmacy Ops & Clinical Programs	Mr.	Sartini	David							David.Sartini@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	01/26/2017	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	1-508-368-9790				HMO - Health Maintenance Organization		C	Boston
H9001	Pharmacy Network Management Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		1-508-368-9660					Benjamin.Barner@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608-2810	09/19/2022	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9001	Pharmacy Technical Help Desk Contact			Help Desk	OptumRx								1600 McConnor Parkway		Schaumburg	IL	60173	12/29/2021	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	1-844-368-8734				HMO - Health Maintenance Organization		C	Boston
H9001	Plan to Plan Reconciliation Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		1-508-368-9085					Shawn.McNamara@fallonhealth.org	One Chestnut Place	10 Chestnut Street	Worcester	MA	01608	12/01/2015	2023	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9003	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	1-562-367-0592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Chief Financial Officer	Vice President & Chief Financial Officer	Ms.	Shepler	Courtney	R	1-510-271-4644					courtney.r.shepler@kp.org	National Medicare Finance, 1 Kaiser Plaza, 13th Floor	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	05/17/2017	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	CMS Casework Communication Contact	Compliance Consultant, Medicare		Lutz	Heidi		1-971-404-7562					heidi.a.lutz@kp.org	500 NE Multnomah St.		Portland	OR	97232	08/07/2020	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Coordination of Benefits Contact	Senior Director		Chung	Clarence		1-562-390-9293				1-562-658-3866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Customer Service Operations Contact			Services	Member		1-800-443-0815					mscc@kp.org	1800 Harrison St., 23rd Floor		Oakland	CA	94612	10/25/2019	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	1-510-271-6835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/10/2014	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		1-858-829-3521					adam.n.salcido@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	12/27/2022	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Medicare Compliance Officer	Compliance Consultant, Medicare	Ms.	Lutz	Heidi		1-971-404-7562					heidi.a.lutz@kp.org	500 NE Multnomah St., Suite 100	Attn: Compliance Department	Portland	OR	97232	01/31/2022	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Part D Exceptions Contact	Executive Director, Member Relations		Osborne	Susan							Susan.A.Osborne@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	10/29/2021	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-877-408-3496				HMO - Health Maintenance Organization		C	San Francisco
H9003	Pharmacy Network Management Contact	National Pharmacy Benefits, Project Manager II		Munoz	Vanessa		1-562-447-7739					Vanessa.L.Munoz@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	10/25/2019	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9003	Pharmacy Technical Help Desk Contact			OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	11/02/2016	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	1-888-791-7245				HMO - Health Maintenance Organization		C	San Francisco
H9003	Plan to Plan Reconciliation Contact	Director, National Medicare & Medicaid Finance		Callender	Margaret		1-510-433-6709					margaret.callender@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	08/14/2017	2023	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9042	Automated TrOOP Balance Transfer Contact	Director of Data Integration & Development	Mr.	Katheeder	Tim		1-812-378-7066					Tim.Katheeder@siho.org	PO Box 1787		Columbus	IN	47202-1787	01/05/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Best Available Evidence Contact	Claims Director		Coomer	Dawn		1-812-314-2500	1106				Dawn.Coomer@siho.org	PO Box 1787		Columbus	IN	47202-1787	07/15/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Chief Financial Officer	Chief Financial Officer	Ms.	Newell	Wendy		1-812-378-7040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47202-1787	08/19/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	CMS Casework Communication Contact	Manager of Quality Assurance		Do	Nicole		1-812-314-2500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/03/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Coordination of Benefits Contact	Manager of Quality Assurance		Do	Nicole		1-812-314-2500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/03/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Customer Service Operations Contact	Director of Customer Service		Diedrich	Bridget		1-812-314-2500	1073				Bridget.Diedrich@siho.org	PO Box 1787		Columbus	IN	47202-1787	10/05/2020	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Government Relations Contact	COO	Mr.	McConnell	Roy		1-832-385-8189					Roy.McConnell@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	05/10/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Hospice Contact	Vice President, Integrated Care Delivery		Kiel	Jordan		1-812-314-2500	1072				jordan.kiel@siho.org	PO Box 1787		Columbus	IN	47202-1787	05/24/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Marx	David		1-812-378-7101					David.Marx@siho.org	417 Washington Street		Columbus	IN	47201	12/13/2022	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Part D Exceptions Contact	Compliance Risk Coordinator		Helsley	Kim							Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/20/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active	1-812-314-2500	1103			PPO - BBA		C	Chicago
H9042	Pharmacy Network Management Contact	Compliance Risk Coordinator		Helsley	Kim		1-812-314-2500	1103				Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	10/22/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9042	Pharmacy Technical Help Desk Contact	Compliance Risk Coordinator		Helsley	Kim							Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/20/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active	1-866-693-4620				PPO - BBA		C	Chicago
H9042	Plan to Plan Reconciliation Contact	Staff Accountant I		Dobbs	Rachel		1-812-314-2500	1202				rachel.dobbs@siho.org	417 Washington Street		Columbus	IN	47201	05/12/2021	2023	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Chicago
H9047	Automated TrOOP Balance Transfer Contact	Business Analyst Systems Coord, Pharmacy	Ms.	Cintron	Alicia		1-503-574-8064				1-503-574-8646	alicia.cintron@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	12/08/2021	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Best Available Evidence Contact	Supervisor- Medicare Membership Accounting		Hopkins	Chantel		1-503-574-5723					chantel.hopkins@providence.org	3601 SW Murray Blvd. Suite 10		Beaverton	OR	97005	05/24/2017	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Chief Financial Officer	Chief Financial Officer	Mr.	Ryan	Dan		1-503-574-6575					Daniel.Ryan@providence.org	4400 NE Halsey ST	Building 2, Suite 690	Portland	OR	97213	05/11/2021	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	CMS Casework Communication Contact	Compliance Medicare Consultant		Saucy	Tara		1-503-574-7431					tara.saucy@providence.org	3601 SW Murray Blvd. Suite 10		Beaverton	OR	97005	11/22/2022	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Coordination of Benefits Contact	Manager-OFT		Parish	Lori		1-503-574-5861					Lori.parish@providence.org	3601 SW Murray Blvd. Suite 10		Beaverton	OR	97005	01/26/2022	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Customer Service Operations Contact	Supervisor Service Ops-Customer Service		Aronson	Elizabeth		1-503-574-6589					Elizabeth.Aronson@providence.org	3601 SW Murray Blvd. Suite 10		Beaverton	OR	97005	11/05/2019	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Government Relations Contact	Chief Compliance & Risk Officer	Mr.	Bals	Aaron		1-503-574-6562					aaron.bals@providence.org	3601 SW Murray Blvd. Suite 10		Beaverton	OR	97005	06/17/2022	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Hospice Contact	Compliance & Product Mgmt Coordinator, Pharmacy		Moore	James		1-503-574-7924					James.Moore@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	03/25/2020	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dunphy	Misty		1-503-574-6608					misty.dunphy@providence.org	3601 SW Murray Blvd. Suite 10		Beaverton	OR	97005	06/17/2022	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Part D Exceptions Contact	Director, Pharmacy		Clark	James							james.clark2@providence.org	3601 SW Murray Blvd. Suite 10		Beaverton	OR	97005	03/02/2022	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active	1-877-216-3644				HMO - Health Maintenance Organization		C	Seattle
H9047	Pharmacy Network Management Contact	VP, Pharmacy	Dr.	Noonan-Harnsberger	Helen	M	1-503-574-5708				1-503-574-8646	Helen.noonan-harnsberger@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	12/23/2020	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9047	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Mr.	Clark	James							james.clark2@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	10/12/2022	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active	1-888-445-5518				HMO - Health Maintenance Organization		C	Seattle
H9047	Plan to Plan Reconciliation Contact	Healthcare Data Analyst		Williams	Rachelle		1-503-574-6316					rachelle.williams@providence.org	3601 SW Murray Blvd, Suite 10		Beaverton	OR	97005	08/09/2021	2023	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence Health & Services	192	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9052	Automated TrOOP Balance Transfer Contact	Director	Mrs.	Vilas	Michele		1-810-388-6300					vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	Best Available Evidence Contact	Director	Mrs.	Vilas	Michele		1-810-388-6300					vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	Chief Financial Officer	Financial Director	Mr.	Visuri	Elliott		1-989-893-4506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	10/01/2021	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	CMS Casework Communication Contact	Director	Mrs.	Vilas	Michele		1-810-388-6300					vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	Coordination of Benefits Contact	Director	Mrs.	Vilas	Michele		1-810-388-6300					vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	Customer Service Operations Contact	Director	Mrs.	Vilas	Michele		1-810-388-6300					vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	Government Relations Contact	Director	Mrs.	Vilas	Michele		1-810-388-6300					vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	Medicare Compliance Officer	Director	Mrs.	Vilas	Michele		1-810-388-6300					vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	Part D Exceptions Contact	Director	Mrs.	Vilas	Michele							vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active	1-810-388-6300				PACE - Nat		C	Chicago
H9052	Pharmacy Network Management Contact	Pharmacist	Mr.	Bergman	Nathaniel		1-989-893-4506	216				bergmann@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	02/18/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9052	Pharmacy Technical Help Desk Contact	Director	Mrs.	Vilas	Michele							vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active	1-888-291-2647				PACE - Nat		C	Chicago
H9052	Plan to Plan Reconciliation Contact	Director	Mrs.	Vilas	Michele		1-810-388-6300					vilasm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	08/08/2022	2023	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active					PACE - Nat		C	Chicago
H9065	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H9065	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H9065	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9066	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mr	Ariglio	Buzz		1-315-870-7772					bariglio@477home.org	1050 West Genesee St		Syracuse	NY	13204	08/16/2021	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Best Available Evidence Contact	Chief Clinical Officer	Ms	Lazarek-Laquay	Andrea		1-315-477-9500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/12/2018	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Chief Financial Officer	Chief Financial Officer	Mr	Ariglio	Buzz		1-315-870-7772					bariglio@477home.org	1050 West Genesee St		Syracuse	NY	13204	08/16/2021	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	CMS Casework Communication Contact	UR Manager	MS	Ginestro	Suzanne		1-315-477-9304					sginestro@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Coordination of Benefits Contact	VP Health Plan Operations	Ms	Frederick	Amanda		1-315-477-9275					afrederick@477home.org	1050 West Genesee St		Syracuse	NY	13204	08/16/2021	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Customer Service Operations Contact	EVP Strategic Operations	Ms	Lindsay	Tammy		1-315-960-1827					tlindsay@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Government Relations Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		1-315-477-9500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Hospice Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		1-315-477-9500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Medicare Compliance Officer	VP Performance Excellence	Ms.	Billington	Janet		1-315-477-9233					MA_Compliance@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/22/2022	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Part D Exceptions Contact	VP	ms	Russo	Joan							jrusso@elixirsolutions.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	08/19/2021	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active	1-917-902-1557				HMO - Health Maintenance Organization		C	New York
H9066	Pharmacy Network Management Contact	Director Pharmacy Network Development and Operatio	Mrs	Profio	Lauren		1-330-486-4864					lprofio@elixirsolutions.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/17/2022	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9066	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	08/19/2021	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active	1-866-250-2005				HMO - Health Maintenance Organization		C	New York
H9066	Plan to Plan Reconciliation Contact	Chief Administrative Officer	Ms	Castle	June		1-315-477-9500				1-315-870-7788	jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/19/2021	2023	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9068	Automated TrOOP Balance Transfer Contact	Treasurer/VP of Finance	Mr.	Blessing	John		1-570-522-3880				1-570-524-9068	john.blessing@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Best Available Evidence Contact	Treasurer/VP of Finance	Mr.	Blessing	John		1-570-522-3880				1-570-524-9068	john.blessing@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Chief Financial Officer	Treasurer/VP of Finance	Mr.	Blessing	John		1-570-522-3880				1-570-524-9068	john.blessing@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	CMS Casework Communication Contact	Corporate Compliance Officer	Mrs.	Shively	Louann		1-570-522-3880				1-570-524-9068	louann.shively@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	02/26/2015	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Coordination of Benefits Contact	Treasurer/VP of Finance	Mr.	Blessing	John		1-570-522-3880				1-570-524-9068	john.blessing@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Customer Service Operations Contact	Corporate Compliance Officer	Mrs.	Shively	Louann		1-570-522-3880				1-570-524-9068	louann.shively@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	02/26/2015	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Government Relations Contact	CEO	Mr.	Smith	Shaun		1-570-522-3880				1-570-524-9068	shaun.smith@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	05/24/2012	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Medicare Compliance Officer	Corporate Compliance Officer	Mrs.	Shively	LouAnn		1-570-522-3880				1-570-524-9068	louann.shively@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	12/03/2013	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part D Exceptions Contact	Corporate Compliance Officer	Mrs.	Shively	Louann						1-570-524-9068	louann.shively@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	02/26/2015	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active	1-570-522-3880				PACE - Nat		C	Philadelphia
H9068	Pharmacy Network Management Contact	Director of Pharmacy	Mrs.	Beitz	Krystal		1-570-523-3108				1-570-523-3109	krystal.beitz@albrightcare.org	110 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Pharmacy Technical Help Desk Contact	Director of Pharmacy	Mrs.	Beitz	Krystal						1-570-523-3109	krystal.beitz@albrightcare.org	110 Maplewood Drive		Lewisburg	PA	17837	02/26/2015	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active	1-570-523-3108				PACE - Nat		C	Philadelphia
H9068	Plan to Plan Reconciliation Contact	Treasurer/VP of Finance	Mr.	Blessing	John		1-570-522-3880				1-570-524-9068	john.blessing@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2023	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9070	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				PPO - BBA		C	Kansas City
H9070	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9070	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				PPO - BBA		C	Kansas City
H9070	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	COMPBENEFITS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H9082	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H9082	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9082	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H9082	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Local CCP	Molina Healthcare of New Mexico, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9096	Automated TrOOP Balance Transfer Contact			Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/05/2019	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Best Available Evidence Contact	Manager - Enrollment & Billing		Kaderabek	Kay		1-608-828-1976					Kay.Kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	06/29/2017	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Chief Financial Officer	Chief Financial Officer	Mr	Ruplinger	Randy		1-608-827-4030					hpmscfo.inbox@deancare.com	1277 Deming Way		Madison	WI	53717	06/15/2017	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	CMS Casework Communication Contact	Director of Claims Operations & Customer Relations		Genin	William	J	1-608-827-4486					William.Genin@deancare.com	1277 Deming Way		Madison	WI	53717	02/05/2016	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Coordination of Benefits Contact	Manager - Enrollment & Billing		Kaderabek	Kay		1-608-828-1976					Kay.Kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	06/29/2017	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Customer Service Operations Contact	Director of Claims Operations  Customer Relations		Genin	William	J	1-608-827-4486					William.Genin@deancare.com	1277 Deming Way		Madison	WI	53717	02/05/2016	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Government Relations Contact	General Counsel, Director of Legal Services		Sutton	Dean		1-608-827-4301					dean.sutton@deancare.com	1277 Deming Way		Madison	WI	53717	02/16/2017	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Hospice Contact	Medicare Compliance Officer		Specht	Jacob		1-608-827-4209					Jacob.Specht@deancare.com	1277 Deming Way		Madison	WI	53717	03/01/2022	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Specht	Jacob		1-608-827-4209					Jacob.Specht@deancare.com	1277 Deming Way		Madison	WI	53717	03/01/2022	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Part D Exceptions Contact	Manager, Medicare Part D Clinical Programs	Mr	Kurzynski	Adam						1-920-221-4622	Adam.Kurzynski@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/05/2019	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-920-221-4122				HMO - Health Maintenance Organization		C	Chicago
H9096	Pharmacy Network Management Contact	Associate Director, Pharmacy Network Management		Miller	Steven		1-920-221-4272				1-920-221-4772	steven.miller@navitus.com	1025 W Navitus Drive		Appleton	WI	54913	08/07/2019	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9096	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-866-595-1975	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/09/2021	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-866-270-3877				HMO - Health Maintenance Organization		C	Chicago
H9096	Plan to Plan Reconciliation Contact	Associate Actuary		Lowenberg	Nicholas		1-608-827-4157					nicholas.lowenberg@deancare.com	1277 Deming Way		Madison	WI	53717	02/25/2020	2023	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage, Prevea360 Medicare Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9104	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations and Formulary		Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Best Available Evidence Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		1-562-637-1234				1-562-989-5243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/28/2019	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Chief Financial Officer	Chief Financial Officer	Mr	Plumb	Michael		1-563-997-1589					MPlumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/02/2020	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	CMS Casework Communication Contact	Director, Reg Audit & Ent Mntrng		Cordova	Elizabeth		1-562-997-3131	3131			1-562-989-5120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/19/2022	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Coordination of Benefits Contact	Director, Pharmacy Operations and Formulary	Ms.	Vaca	Ivette		1-562-997-1544					ivaca@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/03/2022	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		1-562-997-1805				1-562-989-5181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/27/2014	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Government Relations Contact	Sr. Vice President, Public & Government Affairs		Morrell	Adrienne		1-202-349-9008				1-562-989-9439	amorrell@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/12/2019	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Hospice Contact	Manager, Pharmacy Experience and Access	Mr.	Tran	Tri		1-562-308-2884				1-562-997-3196	TMTran@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	02/09/2022	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Medicare Compliance Officer	Compliance Officer	Ms.	Hawkins	Ginette		1-562-308-1195					GHawkins@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/16/2019	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Part D Exceptions Contact	Senior Pharmacy Manager	Mr.	Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-344-3405	733326			HMO - Health Maintenance Organization		C	San Francisco
H9104	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	07/03/2018	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9104	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy	STE 150	Temple Terrace	FL	33637	12/01/2021	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	San Francisco
H9104	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		1-562-989-8300				1-562-989-0101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/09/2019	2023	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9147	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations		Hanson	Michelle		1-612-777-6706					eobp2p@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		1-919-765-2438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Chief Financial Officer	SVP, Chief Financial Officer and Treasurer	Mr.	Perry	Mitchell	W	1-919-765-3923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	02/06/2020	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	CMS Casework Communication Contact	Mgr, Op Qual & Compliance - Regulatory Complaints		Henderson	Nicole		1-919-765-1320					Caseworker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	02/06/2020	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Coordination of Benefits Contact	Team Leader, Claims		McGregory	Ann		1-336-201-4530					Ann.McGregory@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	5660 University Pkwy	Winston Salem	NC	27105	07/15/2022	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		1-919-765-7057					Renita.Woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	07/18/2022	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Government Relations Contact	Director, CMS Contract Administration		Washington-McNeill	Deborah		1-336-692-3556				1-336-659-2969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	5660 University Pkwy	Winston-Salem	NC	27105	02/06/2020	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Hospice Contact	Pharmacy Services Coordinator		Leggett	Ursula		1-919-765-4599					Ursula.Leggett@bcbsnc.com	PO Box 2291		Durham	NC	27702	02/06/2020	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Medicare Compliance Officer	VP,Comml & Medicare Compliance, Compliance Officer	Mrs.	Dreyer	Amber		1-984-960-3306					amber.dreyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	02/06/2020	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Exceptions Contact	Manager		Swanson	Ryan							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/30/2021	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active	1-888-296-9790				HMO - Health Maintenance Organization		C	Atlanta
H9147	Pharmacy Network Management Contact	AVP, Pharmacy Government Programs		Geter	Joseph		1-919-765-7733					joseph.geter@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/17/2022	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							MGarzarodriguez@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2021	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active	1-877-277-7893				HMO - Health Maintenance Organization		C	Atlanta
H9147	Plan to Plan Reconciliation Contact	Manager, Financial Accounting & Reporting		Hitchcock	Grace		1-919-765-7999					grace.hitchcock@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	PO Box 30060 Mailstop 700-1AP	Durham	NC	27702	12/29/2021	2023	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9153	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Heimgartner	Jeremy		1-513-469-8545				1-513-605-6845	betsy.warner@wvsenioradvantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Best Available Evidence Contact	Chief Compliance Officer	Mr	Guzman	Fabian		1-513-240-4810				1-513-605-6845	fguzman@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Chief Financial Officer	CFO	Mr	Heimgarter	Jeremy		1-304-343-1950				1-304-343-1949	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	10/31/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Guzman	Fabian		1-513-469-9586				1-513-605-6845	fguzman@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Coordination of Benefits Contact	Pharmacy Services Manager		Warner	Betsy		1-304-757-9333					betsy.warner@wvsenioradvantage.com	700 Chappell Road		Charleston	WV	25304	04/29/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Customer Service Operations Contact	Director Health Plan Operations		Torrey	Heather		1-513-469-8546				1-513-605-6845	htorrey@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Government Relations Contact	Chief Compliance Officer	Mr.	Guzman	Fabian		1-513-469-9586				1-513-605-6845	fguzman@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Hospice Contact	Chief Medical Officer	Dr.	Schlageck	Joe		1-513-469-8549				1-513-605-6845	jschlageck@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Medicare Compliance Officer	Chief Compliance Officer	Mr	Guzman	Fabian		1-513-469-9586				1-513-605-6845	fguzman@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Part D Exceptions Contact	Assoc. VP of Clinical Operations		Lavingnette	Amanda						1-330-405-8081	calmer@envisionrx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/27/2021	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active	1-833-665-5424				HMO - Health Maintenance Organization		C	Philadelphia
H9153	Pharmacy Network Management Contact	Dir. Pharmacy Network Development and Operations		Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	8921 Canyon Falls Blvd,	Suite 100	Twinsburg	OH	44087	09/21/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9153	Pharmacy Technical Help Desk Contact	VP of Operations		Conn	Todd							tconn@elixirsolutions.com	8921 Canyon Falls Blvd,	Suite 100	Twinsburg	OH	44087	09/21/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active	1-833-665-5423				HMO - Health Maintenance Organization		C	Philadelphia
H9153	Plan to Plan Reconciliation Contact	Chief Financial Officer		Heimgartner	Jeremy		1-513-240-4810				1-513-605-6845	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2023	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		Stonerise Senior Advantage Holdings, LLC	639	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9185	Automated TrOOP Balance Transfer Contact	Health Plan Specialist I		Wahl	Beth		1-989-272-7610					bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	Best Available Evidence Contact	Program Director		Benjamin	David		1-989-272-7610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	Chief Financial Officer	Chief Financial Officer	Mr.	Sen	Tuhin		1-989-272-7610					sen70@cs.com	3378 Fashion Square Blvd		Saginaw	MI	48603	07/19/2018	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	CMS Casework Communication Contact	Program Director		Benjamin	David		1-989-272-7610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	Coordination of Benefits Contact	Health Plan Specialist I		Wahl	Beth		1-989-272-7610					bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	Customer Service Operations Contact	Program Director		Benjamin	David		1-989-272-7610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	Government Relations Contact	Program Director		Benjamin	David		1-989-272-7610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	Medicare Compliance Officer	Quality Assurance Coordinator	Mrs	Hurley	Ashley		1-989-272-7610				1-989-272-7669	ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	Part D Exceptions Contact	Program Director	Mr.	Benjamin	David						1-989-272-7669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active	1-844-445-7223				PACE - Nat		C	Chicago
H9185	Pharmacy Network Management Contact	Program Director		Benjamin	David		1-989-272-7610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9185	Pharmacy Technical Help Desk Contact	Program Director	Mr.	Benjamin	David						1-989-272-7669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active	1-844-445-7223				PACE - Nat		C	Chicago
H9185	Plan to Plan Reconciliation Contact	Health Plan Specialist I		Wahl	Beth		1-989-272-7610					bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2023	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Chicago
H9191	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Dr	Ford	James	E	1-443-275-9801					jford@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	01/30/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Best Available Evidence Contact	Director of Partner Development	Ms	Radice	Sue		1-410-991-3213				1-844-462-3091	sradice@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	01/30/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Chief Financial Officer	CFO	Mr	Persinger	Keith		1-410-456-3946					kpersinger@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	12/29/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	CMS Casework Communication Contact	Chief Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/03/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Coordination of Benefits Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	01/17/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Customer Service Operations Contact	Sr. Director of Operations	Mr.	Brain	Jay		1-240-367-2626					JBrain@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	09/29/2021	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Government Relations Contact			Grindrod	Rick		1-410-424-0772					rgrindrod@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	01/30/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Hospice Contact	Account Manager	Ms.	Sousa	Ana		1-215-872-4933					asousa@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	01/30/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Medicare Compliance Officer	Compliance Officer	Mr.	Nunez	Kenneth		1-813-230-1048					knunez@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	11/10/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Part D Exceptions Contact	Associate Vice President	Ms	Lavignette	Amanda							alavignette@envsionrx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	11/10/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Philadelphia
H9191	Pharmacy Network Management Contact	Director Pharmacy Network Development & Operations	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9191	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/14/2022	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	1-844-846-8007				HMO - Health Maintenance Organization		C	Philadelphia
H9191	Plan to Plan Reconciliation Contact	Director of Finance	Ms	McIntyre	Mary Beth		1-410-967-2097					mmcintyre@pphealthplan.com	785 Elkridge Landing Road	Suite 300	Linthicum Heights	MD	21090	01/17/2020	2023	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy Operations		Vangala	Ramesh		1-215-219-7864				1-215-967-4482	troop@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	12/29/2021	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Best Available Evidence Contact	Director, Enrollment		Johnson	Christophe		1-215-991-4320				1-215-967-9267	cjohnson@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	08/25/2014	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Chief Financial Officer	Chief Financial Officer	Mr.	Clancy	Kevin		1-267-831-5363					Kclancy@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	05/29/2020	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	CMS Casework Communication Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		1-215-991-4023					Lwatkins@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	06/01/2021	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Coordination of Benefits Contact	Vice President, Pharmacy Operations		Vangala	Ramesh		1-215-219-7864				1-215-967-4482	cob@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	12/29/2021	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Customer Service Operations Contact	SVP Information Systems & CIO	Mr.	Brand	Joseph		1-215-991-4013					jbrand@hpplans.com	901 Market Street		Philadelphia	PA	19107	03/10/2020	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Government Relations Contact	Compliance Officer	Mr.	Adams	Shawn		1-267-918-3882					sadams@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	12/23/2021	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Hospice Contact	Manager, Pharmacy Regulations & Implementations		McCaffrey	Hannah		1-215-965-7142					pharmacymedicare@hpplans.com	901 Market Street		Philadelphia	PA	19107	07/20/2022	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Medicare Compliance Officer	Compliance Officer	Mr.	Adams	Shawn		1-267-918-3882					sadams@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	12/23/2021	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Part D Exceptions Contact	Director, Pharmacy Services		Dolores	Danielle						1-866-371-3239	Exceptions@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	07/20/2022	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active	1-215-991-4329				HMO - Health Maintenance Organization		C	Philadelphia
H9207	Pharmacy Network Management Contact	Vice President Pharmacy Operations		Vangala	Ramesh		1-215-219-7864				1-215-967-4482	Pharmacynetwork@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	12/29/2021	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9207	Pharmacy Technical Help Desk Contact	Director, Pharmacy Services		Dolores	Danielle						1-215-967-9270	Formulary@hpplans.com	901 Market St	Suite 500	Philadelphia	PA	19107	12/06/2022	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active	1-866-841-7659				HMO - Health Maintenance Organization		C	Philadelphia
H9207	Plan to Plan Reconciliation Contact	Pharmacy Regulatory Business Coordinator		Rutledge-Glazov	Rose	A	1-215-965-7142				1-215-967-9263	P2P@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	10/20/2022	2023	HEALTH PARTNERS PLANS, INC.	Local CCP	Health Partners Medicare	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9219	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H9219	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9219	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H9219	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9231	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H9231	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9231	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H9231	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9239	Automated TrOOP Balance Transfer Contact	Director, Business Process		Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	CMS Casework Communication Contact	Associate Analyst, Regulatory Adherence		Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Coordination of Benefits Contact	Director, Business Process		Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Customer Service Operations Contact	Vice President, Customer Service		Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Hospice Contact	Director, Business Process		Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Part D Exceptions Contact	Director, Business Process		Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Pharmacy Network Management Contact	Director, Business Process		Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Pharmacy Technical Help Desk Contact	Director, Business Process		Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Demo Risk Option C	MMP HMO Demo	C	Boston
H9239	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	03/25/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Demo	UnitedHealthcare	Medicare-Medicaid Plan HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9252	Automated TrOOP Balance Transfer Contact	Director PACE Program Development & Implementation		Kiefert	Mary		1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	Best Available Evidence Contact	Director PACE Program Development & Implementation		Kiefert	Mary	D	1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Rd		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	Chief Financial Officer	EVP and Chief Financial Officer	Mr.	Mendez	Alex		1-305-674-2089					alex.mendez@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	CMS Casework Communication Contact	Director PACE Program Development & Implementation		Kiefert	Mary		1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	Coordination of Benefits Contact	Director PACE Program Development & Implementation		Kiefert	Mary		1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	Customer Service Operations Contact	Director PACE Program Development & Implementation		Kiefert	Mary		1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	Government Relations Contact	Director PACE Program Development & Implementation		Kiefert	Mary		1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	Medicare Compliance Officer	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	Part D Exceptions Contact			Kiefert	Mary							mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending	1-904-234-4338				PACE - Nat		C	Atlanta
H9252	Pharmacy Network Management Contact	Director PACE Program Development & Implementation		Kiefert	Mary		1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9252	Pharmacy Technical Help Desk Contact			Kiefert	Mary							mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending	1-904-234-4338				PACE - Nat		C	Atlanta
H9252	Plan to Plan Reconciliation Contact	Director PACE Program Development & Implementation		Kiefert	Mary		1-904-234-4338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2023	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Pending					PACE - Nat		C	Atlanta
H9258	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H9258	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9258	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H9258	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF RHODE ISLAND, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9266	Automated TrOOP Balance Transfer Contact	Health Plan and Compliance Manager	Ms.	Rivera	Kisha		1-336-506-0445	1407			1-919-933-9201	riverak@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/27/2021	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Best Available Evidence Contact	Health Plan and Compliance Manager	Ms.	Rivera	Kisha		1-336-506-0445	1407			1-919-933-9201	Riverak@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/27/2021	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Chief Financial Officer	CFO	Ms.	Mason	Lydia		1-919-537-7483				1-919-933-9201	masonly@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hil	NC	27514	01/13/2020	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	CMS Casework Communication Contact	Executive Director, Piedmont Health SeniorCare	Mr.	Sumpter	Jeffrey		1-919-545-7341				1-919-933-9201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Coordination of Benefits Contact	Health Plan and Compliance Manager	Ms.	Rivera	Kisha		1-336-506-0445	1407			1-919-933-9201	riverak@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/27/2021	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Customer Service Operations Contact	Health Plan and Compliance Manager	Ms.	Rivera	Kisha		1-336-506-0445	1407			1-919-933-9201	riverak@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/27/2021	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Government Relations Contact	Health Plan Manager	Ms.	Rivera	Kisha		1-336-506-0445	1407			1-919-933-9201	riverak@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/01/2021	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Medicare Compliance Officer	PACE Executive Director	Mr.	Sumpter	Jeffrey		1-919-545-7341				1-919-933-9201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Part D Exceptions Contact	Associate Director of Pharmacy Administration	Mrs.	Stout	Kelly						1-336-532-0001	stoutk@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	09/23/2016	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	1-877-714-2100				PACE - Nat		C	Atlanta
H9266	Pharmacy Network Management Contact	Associate Director of Pharmacy Administration	Mrs.	Stout	Kelly		1-336-506-0441				1-336-532-0001	stoutk@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	09/23/2016	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Pharmacy Technical Help Desk Contact	Associate Director of Pharmacy Administration	Mrs.	Stout	Kelly						1-336-532-0001	stoutk@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	09/23/2016	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	1-877-714-2100				PACE - Nat		C	Atlanta
H9266	Plan to Plan Reconciliation Contact	Health Plan Manager	Ms.	Rivera	Kisha		1-336-506-0445				1-919-933-9201	riverak@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/01/2021	2023	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9276	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	CMS Casework Communication Contact	Sr. Director, Operations	Ms	Dolic Muratagic	Emsija		1-314-236-4606					emsija.DolicMuratagic@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	03/30/2021	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Government Relations Contact	Vice President, Complex Care Products	Ms.	Arden	Gale		1-314-725-4477	47759				garden@centene.com	7700 Forsyth Blvd		St. Louis	MO	63105	05/16/2019	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H9276	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9276	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H9276	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Local CCP	Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9302	Automated TrOOP Balance Transfer Contact	Director PBM Operations	Ms.	Barnhart	Lisa		1-513-317-6662					lisa.barnhart@advantasure.com	Advantasure, Inc.	134 Turnpike Road	Southborough	MA	01772	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Best Available Evidence Contact	Senior Manager, Medicare Operations	Ms.	Browne	Kris		1-425-918-4213					kris.browne@premera.com	Premera Blue Cross	7001 220th St. SW	Mountlake Terrace	WA	98043	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Chief Financial Officer	EVP, Chief Financial Officer	Mr.	Risse	Thomas		1-425-918-3926					thomas.risse@premera.com	Premera Blue Cross	7001 220th St. SW	Mountlake Terrace	WA	98043	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	CMS Casework Communication Contact	Sr. Med Adv Compliance Program Adm	Ms.	Connolly	Shawnna		1-425-918-3867				1-425-918-4163	shawnna.connolly@premera.com	Premera Blue Cross	7001 220th St. SW, MS 221	Mountlake Terrace	WA	98043	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Coordination of Benefits Contact	Enrollment and COB Manager	Ms.	LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	Advantasure, Inc.	1000 Town Center, 15th floor	Southfield	MI	48073	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Customer Service Operations Contact	Manager	Ms.	Woods	Remy		1-313-225-7369					rwoods2@bcbsm.com	Advantasure, Inc.	4121 Cox Road, Ste. 200	Glen Allen	VA	23060	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Government Relations Contact	Medicare Compliance Officer	Ms.	Badgley	Jennifer		1-425-918-5400				1-425-918-4163	jennifer.badgley@premera.com	Premera Blue Cross	7001 220th St. SW, MS 221	Mountlake Terrace	WA	98043	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Hospice Contact	Pharmacy Manager, Clinical Programs	Ms.	Polzin	Jennifer		1-425-381-8236					jennifer.polzin@premera.com	Premera Blue Cross	7001 220th St. SW	Mountlake Terrace	WA	98043	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Badgley	Jennifer		1-425-918-5400				1-425-918-4163	jennifer.badgley@premera.com	Premera Blue Cross	7001 220th St. SW, MS 221	Mountlake Terrace	WA	98043	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Part D Exceptions Contact	Clnical Pharmacist	Ms.	Wiff	Roy							roy.wiff@advantasure.com	Advantasure, Inc.	4121 Cox Road, Ste. 200	Glen Allen	VA	23060	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active	1-614-439-9079				HMO - Health Maintenance Organization		C	Seattle
H9302	Pharmacy Network Management Contact	Pharmacy Manager	Ms.	Polzin	Jennifer		1-425-918-6350					jennifer.polzin@premera.com	Premera Blue Cross	7001 220th St. SW	Mountlake Terrace	WA	98043	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9302	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy								CVS Health	9501 E. Shea Blvd.	Scottsdale	AZ	85260	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Seattle
H9302	Plan to Plan Reconciliation Contact	Director - Actuarial Services	Mr.	Allard	Gilbert		1-425-918-5357					gilbert.allard@premera.com	Premera Blue Cross Attn: P2P	P.O. Box 91060	Seattle	WA	98111	01/04/2023	2023	PREMERA BLUE CROSS	Local CCP	Premera Blue Cross Medicare Advantage	HMO/HMOPOS		Premera	537	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Automated TrOOP Balance Transfer Contact	VP, Clinical Program Strategy & Integration	Ms	Borja	Asuncion	D	1-443-318-1076				1-410-801-5703	sborja@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	11/15/2021	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Best Available Evidence Contact	Medicare Program Director	Ms	Zahangir	Nadia		1-347-307-5868				1-443-318-1060	nzahangir@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Chief Financial Officer	Chief Financial Officer	Mr	Yancisin	Matt		1-443-884-9108				1-443-558-7809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	CMS Casework Communication Contact	Director of Operations	Ms	Goss	April		1-667-290-5601				1-410-801-5704	agoss@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Coordination of Benefits Contact	Medicare Program Director	Ms	Zahangir	Nadia		1-347-307-5868				1-443-318-1060	nzahangir@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Customer Service Operations Contact	Director of Operations	Ms	Goss	April		1-667-290-5601				1-410-801-5704	agoss@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Government Relations Contact	Chief Marketing Officer	Mr	Davis	James		1-443-884-9082				1-410-801-5865	jdavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Hospice Contact	Chief Health & Quality Officer	Ms	Bavis	Jill		1-443-884-9083				1-443-558-7809	jbavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	06/23/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Medicare Compliance Officer	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		1-410-446-6506				1-240-201-9079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Part D Exceptions Contact	VP, Clinical Program Strategy & Integration	Ms	Borja	Asuncion	D					1-410-801-5703	sborja@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	09/07/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active	1-866-267-3144				HMO - Health Maintenance Organization		C	Philadelphia
H9306	Pharmacy Network Management Contact	Director Pharmacy Network Dev and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/07/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9306	Pharmacy Technical Help Desk Contact	VP Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	8921 Canyon Falls Blvd	Suite 100	Twinsburg	OH	44087	09/07/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active	1-833-693-2189				HMO - Health Maintenance Organization		C	Philadelphia
H9306	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Yancisin	Matt		1-443-884-9108				1-443-558-7809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2023	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		Alterwood Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9317	Automated TrOOP Balance Transfer Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	06/10/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	Best Available Evidence Contact	CFO		Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	06/10/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	Chief Financial Officer	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	CMS Casework Communication Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@srpathways.com	134 Mary Hill Road		Phoenixville	PA	19460	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	Coordination of Benefits Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	Customer Service Operations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@srpathways.com	134 Mary Hill Road		Phoenixville	PA	19460	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	Government Relations Contact	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@srpathways.com	134 Mary Hill Road		Phoenixville	PA	19460	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	Medicare Compliance Officer	PACE Consultant	Mrs	Austin	Mary		1-215-609-8714					maustin@srpathways.com	134 Mary Hill Road		Phoenixville	PA	19460	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	Part D Exceptions Contact	CFO		Prentis	Kristin							kprentiss@acutecarehs.com	106 West Moore Avenue, Suite A		Mooresville	NC	28115	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending	1-732-806-3224				PACE - Nat		C	Atlanta
H9317	Pharmacy Network Management Contact	Executive Director		Friedman	Pinni		1-732-592-3400					Pfriedman@acutecarehs.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9317	Pharmacy Technical Help Desk Contact	Executive Director		Friedman	Pinni							Pfriedman@acutecarehs.com	1075 Stephenson Avenue, SUite B		Oceanport	NJ	07757	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending	1-732-592-3400				PACE - Nat		C	Atlanta
H9317	Plan to Plan Reconciliation Contact	CFO	Mrs	Prentis	Kristin		1-732-806-3224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	06/11/2021	2023	BEACON OF LIFE SC, LLC	National PACE	Beacon of Life SC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9323	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Ms.	Prentiss	Kristin	C	1-732-806-3224				1-732-806-3324	kprentiss@acutecarehs.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/26/2018	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	Best Available Evidence Contact	Executive Director	Ms.	Runyon	Bobbi		1-732-592-3401				1-732-592-3501	brunyon@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	07/05/2022	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	Chief Financial Officer	Chief Financial Officer	Ms.	Prentiss	Kristin	C	1-732-806-3224				1-732-806-3324	kprentiss@acutecarehs.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/26/2018	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	CMS Casework Communication Contact	Executive Director	Ms.	Runyon	Bobbi		1-732-592-3401				1-732-592-3501	brunyon@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	07/05/2022	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	Coordination of Benefits Contact	Chief Financial Officer	Ms.	Prentiss	Kristin	C	1-732-806-3224				1-732-806-3324	kprentiss@acutecarehs.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/26/2018	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	Customer Service Operations Contact	Quality Director		Thompson	Evelyn		1-732-592-3407				1-732-592-3507	ethompson@beaconhss.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/29/2021	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	Government Relations Contact	Executive Director	Ms.	Runyon	Bobbi		1-732-592-3401				1-732-592-3501	brunyon@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	07/05/2022	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	Medicare Compliance Officer	Chief Financial Officer	Ms.	Prentiss	Kristin		1-732-806-3224				1-732-806-3324	kprentiss@acutecarehs.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/09/2017	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	Part D Exceptions Contact	Chief Financial Officer	Ms.	Prentiss	Kristin	C					1-732-806-3324	kprentiss@acutecarehs.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/26/2018	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active	1-180-000-0000				PACE - Nat		C	New York
H9323	Pharmacy Network Management Contact	Executive Director	Ms.	Runyon	Bobbi		1-732-592-3401				1-732-592-3501	brunyon@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	07/05/2022	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9323	Pharmacy Technical Help Desk Contact	Executive Director	Ms.	Runyon	Bobbi							brunyon@beaconpace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/05/2022	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active	1-732-592-3400				PACE - Nat		C	New York
H9323	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Prentiss	Kristin	C	1-732-806-3224				1-732-806-3324	kprentiss@acutecarehs.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/26/2018	2023	ACUTE CARE HEALTH SYSTEM, LLC	National PACE	Beacon of LIFE PACE	National PACE		Acute Care Health System, LLC	682	Yes	Active					PACE - Nat		C	New York
H9335	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H9335	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9335	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H9335	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MISSOURI, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9357	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/17/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/10/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	02/02/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/10/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H9357	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9357	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H9357	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	CENTENE VENTURE INSURANCE COMPANY TEXAS	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9360	Automated TrOOP Balance Transfer Contact			Cheng	Jack		1-213-808-1709					jacheng@cscla.org	767 N. Hill Street		Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	Best Available Evidence Contact			Cheng	Jack		1-213-808-1709					jacheng@cscla.org	767 N. Hill Street		Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	Chief Financial Officer	CFO	Ms.	Ramos	Yeryca		1-213-808-1702					yramos@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/22/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	CMS Casework Communication Contact	COO	Mr.	Cheng	Jack		1-213-808-1709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	Coordination of Benefits Contact	COO	Mr.	Cheng	Jack		1-213-808-1709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	Customer Service Operations Contact	COO	Mr.	Cheng	Jack		1-213-808-1709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	Government Relations Contact	CEO	Mr.	Ng	Peter		1-213-808-1701					png@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/22/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	Medicare Compliance Officer	COO	Mr.	Cheng	Jack		1-213-808-1709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	Part D Exceptions Contact			Cheng	Jack							jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending	1-213-808-1709				PACE - Nat		C	San Francisco
H9360	Pharmacy Network Management Contact	COO	Mr.	Cheng	Jack		1-213-808-1709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9360	Pharmacy Technical Help Desk Contact			Cheng	Jack							jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending	1-213-808-1709				PACE - Nat		C	San Francisco
H9360	Plan to Plan Reconciliation Contact	COO	Mr.	Cheng	Jack		1-213-808-1709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2023	CHINATOWN SERVICE CENTER	National PACE	www.cscla.org	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9364	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H9364	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9364	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H9364	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9387	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	01/29/2020	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H9387	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9387	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H9387	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9403	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-614-336-3326				HMO - Health Maintenance Organization		C	Chicago
H9403	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9403	Pharmacy Technical Help Desk Contact			Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	08/04/2021	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H9403	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (SC), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9411	Automated TrOOP Balance Transfer Contact	CEO		Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Best Available Evidence Contact	CEO		Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Chief Financial Officer	CEO	Mr.	Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave		Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	CMS Casework Communication Contact	CEO	Mr.	Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave		Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Coordination of Benefits Contact	CEO		Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Customer Service Operations Contact	CEO		Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Government Relations Contact	CEO		Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Medicare Compliance Officer	CEO	Mr.	Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave		Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Part D Exceptions Contact			Ko	David							edenhospicecare@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending	1-213-596-9119				PACE - Nat		C	San Francisco
H9411	Pharmacy Network Management Contact		Dr.	Lee	Young-Jik		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave		Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Pharmacy Technical Help Desk Contact			Ko	David							edenhospicecare@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending	1-213-596-9119				PACE - Nat		C	San Francisco
H9411	Plan to Plan Reconciliation Contact	CEO		Ko	David		1-213-596-9119					edenhospicecare@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/28/2020	2023	1818 WESTERN, LLC	National PACE	Asian Heritage Healthcare	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9412	Automated TrOOP Balance Transfer Contact	Manager, Government Programs	Mr.	Merkel	Patrick		1-570-214-4692				1-570-214-1367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Best Available Evidence Contact	Director, Health Plan Operations - Enrollment	Ms.	Kinney	Noelle	C	1-570-214-9270					nckinney@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	10/25/2021	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Chief Financial Officer	COO/CFO	Mr.	McCullough	Mark	A	1-570-214-0783					mmccullough1@thehealthplan.com	100 North Academy Avenue		Danville	PA	17822	11/18/2020	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	CMS Casework Communication Contact	Customer Service Team Coordinator		Peters	Joanne		1-570-214-3285				1-570-271-5970	jpeters@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	12/31/2015	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Coordination of Benefits Contact	Supervisor, Health Plan COB	Ms.	Minium, CPC	Joanne		1-570-849-7572					COB@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3251	04/20/2022	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Customer Service Operations Contact	Director, Health Plan Operations, Customer Care	Mr.	Sanders	John	R	1-570-214-8046					jrsanders@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-2580	11/01/2019	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Government Relations Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	1-570-214-2193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3220	06/24/2022	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Hospice Contact	Claims and Benefits Auditor, GHP Pharmacy	Ms.	Seabrook	Naiki	A	1-570-214-7851				1-570-300-2122	naseabrook@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3245	11/01/2019	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Masser	Philip	J	1-570-214-9281				1-570-214-5305	pjmasser@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3220	09/22/2015	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Part D Exceptions Contact	Director, Pharmacy Services	Dr.	Miller	Jamie						1-570-214-6768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822-3245	12/22/2017	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active	1-800-988-4861				PPO - BBA		C	Philadelphia
H9412	Pharmacy Network Management Contact	PerformRx Director, Service Operations	Ms.	Leal MBA CHIE	Avelina		1-215-863-6540					aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/28/2020	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9412	Pharmacy Technical Help Desk Contact	PerformRx Director, Service Operations	Ms	Leal MBA CHIE	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/21/2021	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active	1-855-508-1715				PPO - BBA		C	Philadelphia
H9412	Plan to Plan Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		1-570-214-4692				1-570-214-1367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2023	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Geisinger Health	96	Yes	Active					PPO - BBA		C	Philadelphia
H9414	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment and Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2022	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Best Available Evidence Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931				randrade@commonwealthcare.org	30 Winter St		Boston	MA	02108	02/05/2021	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Chief Financial Officer	Chief Financial Officer	Ms.	Hamilton	Mary		1-857-327-1953					mahamilton@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	CMS Casework Communication Contact	Director, Appeals& Grievances		Schenk	Tyrone		1-857-327-3320				1-857-453-4517	tschenk@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/29/2022	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Coordination of Benefits Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931			1-617-426-3109	randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/05/2021	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Customer Service Operations Contact	VP, Customer Service		Habib	Fred		1-617-426-0600	1504			1-617-426-3097	fhabib@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/21/2021	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Government Relations Contact	VP, Government Relations		Preede	Ken		1-617-426-0600	51412				kpreede@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/30/2022	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Hospice Contact	Palliative Care Medical Director		Ragland	Julia		1-781-525-4203					jragland@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	10/04/2022	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	Lavallee	Katherine		1-617-947-5780					KLavalee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/01/2022	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Part D Exceptions Contact	Sr. Manager, Clinical Prior Auth		LeClair	Christophe						1-920-221-4676	Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/25/2021	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877				PPO - BBA		C	Boston
H9414	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@Navitus.com	361 Integrity Drive		Madison	WI	53713	03/25/2021	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9414	Pharmacy Technical Help Desk Contact	Sr. Mgr, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	53713	03/25/2021	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877	4224			PPO - BBA		C	Boston
H9414	Plan to Plan Reconciliation Contact	Accounts Receivable Coordinator		Newman	Elaine		1-617-426-0600	52580				enewman@commonwealthcare.org	30 Winter St		Boston	MA	02108	08/25/2022	2023	Commonwealth Care Alliance Massachusetts, LLC.	Local CCP	Commonwealth Care Alliance Massachusetts	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9428	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/15/2022	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/15/2022	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H9428	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9428	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H9428	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE OF TENNESSEE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9431	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/15/2020	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/24/2022	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/24/2022	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/24/2022	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-602-618-3945				PPO - BBA		C	Philadelphia
H9431	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9431	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	1-800-238-6279				PPO - BBA		C	Philadelphia
H9431	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/24/2022	2023	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Philadelphia
H9438	Automated TrOOP Balance Transfer Contact	PACE Director of Accounting		Conner	Dee		1-316-836-4880				1-316-836-4250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	Best Available Evidence Contact	PACE Director of Accounting		Conner	Dee		1-316-836-4880				1-316-836-4250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	Chief Financial Officer	CFO	Mr.	Schrag	Jerol		1-316-284-2900				1-316-284-0173	jerols@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	CMS Casework Communication Contact	PACE Operations Director	Ms.	Lefort	Chris		1-620-504-5917				1-620-504-5674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	Coordination of Benefits Contact	PACE Director of Accounting		Conner	Dee		1-316-836-4880				1-316-836-4250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	Customer Service Operations Contact	CEO	Mr.	Loewen	Justin		1-620-504-5950				1-620-504-5674	justinl@bluestemks.org	113 South Ash		McPherson	KS	67460	10/07/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	Government Relations Contact	CEO	Mr.	Loewen	Justin		1-620-504-5950				1-620-504-5674	justinl@bluestemks.org	113 South Ash		McPherson	KS	67460	10/07/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	Medicare Compliance Officer	PACE Director of Accounting	Ms	Conner	Dee		1-316-836-4880				1-316-836-4250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	04/19/2022	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	Part D Exceptions Contact	PACE Director of Accounting		Conner	Dee						1-316-836-4250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active	1-800-836-4880				PACE - Nat		C	Kansas City
H9438	Pharmacy Network Management Contact	CEO	Mr.	Loewen	Justin		1-620-504-5950				1-620-504-5674	justinl@bluestemks.org	113 South Ash		McPherson	KS	67460	10/07/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9438	Pharmacy Technical Help Desk Contact			Schrag	Jerol						1-316-284-0173	jerols@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	07/15/2015	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active	1-316-284-2900				PACE - Nat		C	Kansas City
H9438	Plan to Plan Reconciliation Contact	PACE Director of Accounting		Conner	Dee		1-316-836-4880				1-316-836-4250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2023	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	Kansas City
H9455	Automated TrOOP Balance Transfer Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	02/23/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Best Available Evidence Contact	Sales Coordinator		Johnson	Linda		1-385-414-0793					Linda.Johnson@healthchoiceutah.com	6056 S Fashion Square Drive	Suite 2400	Murray	UT	84107	06/14/2021	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Chief Financial Officer	Director, Finance	Mr	Finlinson	Doug		1-801-587-2675					DOUG.FINLINSON@hsc.utah.edu	6053  Fashion Square Drive	Suite 110	Murray	UT	84107	09/07/2021	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	CMS Casework Communication Contact	Appeals Manager	Ms.	Willey	Katie		1-801-213-0291					Katie.Willey@hsc.utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	12/19/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Coordination of Benefits Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	02/23/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Customer Service Operations Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	02/23/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Government Relations Contact	Compliance Manager	Mr.	Christensen	Eric		1-801-213-0292					eric.n.christensen@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	12/19/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Hospice Contact	Supervisor Part D Operations		Maples	David		1-801-213-0099					David.Maples@utah.edu	6053 S Fashion Square Dr.	Suite 110	Murray	UT	84107	01/04/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Medicare Compliance Officer	Compliance Manager	Mr.	Christensen	Eric		1-801-213-0292					eric.n.christensen@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	12/19/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Part D Exceptions Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David							David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	02/23/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active	1-801-213-0099				HMO - Health Maintenance Organization		C	Dallas
H9455	Pharmacy Network Management Contact	Medicare Advantage Part D Oversight Supervisor	Mr	Maples	David		1-801-213-0099				1-801-213-1547	David.Maples@utah.edu	6053 S Fashion Square Dr. Suite 110		Murray	UT	84107	02/23/2022	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9455	Pharmacy Technical Help Desk Contact	CVS Health Technical Help Desk		Help Desk	CVS								CVS Health	9501 E Shea Blvd	Scottsdale	AZ	85260	12/20/2021	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Dallas
H9455	Plan to Plan Reconciliation Contact	Controller	Mr	Soliman	Bishoy		1-480-278-3506					Bishoy.Soliman@healthchoiceutah.com	6056 S Fashion Square Drive	Suite 2400	Murray	UT	84107	06/14/2021	2023	HEALTH CHOICE UTAH, INC.	Local CCP	Health Choice Generations Utah	HMO/HMOPOS		University of Utah	762	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9460	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O'Donnell Street		Baltimore	MD	21224	11/09/2022	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O'Donnell Street		Baltimore	MD	21224	11/09/2022	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H9460	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H9460	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	CIGNA HEALTHCARE OF ST LOUIS, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9468	Automated TrOOP Balance Transfer Contact	VP Quality Finance	Mrs.	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street , Suite 201		Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	Best Available Evidence Contact	VP Quality Finance	Mrs.	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street , Suite 201		Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	Chief Financial Officer	CFO	Mr.	Phillips	Jeffery		1-814-456-5433					jphillips@lifenwpa.org	100 State Street, Suite 201		Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	CMS Casework Communication Contact	CEO	Mr.	Fish	Richard		1-814-456-5433					rfish@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street   Suite 201	Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	Coordination of Benefits Contact	VP Quality Finance	Mrs.	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street , Suite 201		Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	Customer Service Operations Contact	Director of Center Operation	Mrs.	Kraus	Lisa		1-814-456-5433					MedD-CM@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street, Suite 201	Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	Government Relations Contact	CEO	Mr.	Fish	Richard		1-814-456-5433					rfish@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street   Suite 201	Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	Medicare Compliance Officer	Director of Quality	Ms	McClure	Shelby		1-814-413-1495					smcclure@lifenwpa.org	100 State Street , suite 201		Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	Part D Exceptions Contact	VP Contracts-Part D	Mr.	Feldmann	William							HPMS-MedD@lifenwpa.org	100 State Street, Suite 201		Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending	1-814-456-5433				PACE - Nat		C	Philadelphia
H9468	Pharmacy Network Management Contact	Medical Director	Dr.	Shaffer	Kevin		1-814-456-5433					kshaffer@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street, Suite 201	Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9468	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Shaffer	Kevin							kshaffer@lifenwpa.org	LIFE-NWPA -- MED-D Administration	100 State Street, Suite 201	Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending	1-814-456-5433				PACE - Nat		C	Philadelphia
H9468	Plan to Plan Reconciliation Contact	VP Quality Finance	Mrs.	Kachersky	Jennifer		1-814-456-5433					HPMS-Finance@lifenwpa.org	100 State Street , Suite 201		Erie	PA	16507	12/19/2022	2023	ONE SENIOR CARE KENTUCKY, LLC	National PACE	One Senior Care Kentucky, LLC	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H9469	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	01/10/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	01/10/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	01/10/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	01/10/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				PPO - BBA		C	Chicago
H9469	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-833-377-4266					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	12/08/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9469	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	12/08/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				PPO - BBA		C	Chicago
H9469	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	01/10/2022	2023	UNICARE LIFE AND HEALTH INSURANCE COMPANY	Local CCP	Simply Healthcare	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H9485	Automated TrOOP Balance Transfer Contact	Director, Pharmacy		Gallagher	Angela		1-857-282-2493					agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Best Available Evidence Contact	Director, Enrollment		Fishkin	Carly		1-857-282-2762					cfishkin@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	08/20/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Chief Financial Officer	CFO	Ms	Silva	Lucy		1-207-939-4468					lsilva@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	12/20/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	CMS Casework Communication Contact	Director, Quality		Sahar	Maurice		1-857-282-9076					msahar@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	07/06/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Coordination of Benefits Contact	Manager, Recoveries		Ryan	Cathy		1-857-282-9131					cryan@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Customer Service Operations Contact	Director, Customer Services		Biron	Jonathan		1-857-282-9082					jbiron@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Government Relations Contact	Director, Government Affairs		Sullivan	John		1-857-282-3376					jsullivan@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Hospice Contact	Director, Pharmacy		Gallagher	Angela		1-857-282-2493					agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Trembley	Shannon		1-207-939-4468					STrembley@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	09/27/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Part D Exceptions Contact	Director, Pharmacy		Gallagher	Angela							agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active	1-857-282-2493				PPO - BBA		C	Boston
H9485	Pharmacy Network Management Contact	Director, Pharmacy		Gallagher	Angela		1-857-282-2493					agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9485	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Gallagher	Angela							agallagher@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active	1-866-693-4620				PPO - BBA		C	Boston
H9485	Plan to Plan Reconciliation Contact	Controller		Tang	Tak		1-857-282-3317					ttang@allwayshealth.org	399 Revolution Dr		Somerville	MA	02145	02/15/2022	2023	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active					PPO - BBA		C	Boston
H9489	Automated TrOOP Balance Transfer Contact	Sr. Project Manager		Rush	Jamie		1-314-354-1103					ESITroopTransfer@express-scripts.com	One Express Way		St.Louis	MO	63121	02/05/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Best Available Evidence Contact	Manager, Enrollment and Billing		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road Suite 200		Glen Allen	VA	23060	06/17/2022	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Chief Financial Officer	SVP, Controller	Mr.	Pisarik	Jason		1-248-665-4348					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	VT	05601	02/07/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	CMS Casework Communication Contact	Compliance Consultant		White	Jasmin		1-248-665-4235					JWhite4@bcbsm.com	1000 Town Center		Southfield	MI	48075	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Coordination of Benefits Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	03/22/2022	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Customer Service Operations Contact	Director, Workforce Management, Analytics, & Supp		Weber	Julie		1-313-225-0555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	11/15/2021	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Government Relations Contact	Manager, Performance and Oversight		Martell	Stacey		1-313-806-5905					smartell@bcbsm.com	1000 Town Center		Southfield	MI	48075	04/16/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Hospice Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		1-954-498-5880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-614-336-3326				HMO - Health Maintenance Organization		C	Chicago
H9489	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Healther		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St.Louis	MO	63121	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9489	Pharmacy Technical Help Desk Contact	Director of Operations, Contact Center		Liu	Ian							iliu@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Chicago
H9489	Plan to Plan Reconciliation Contact	SVP, Controller		Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2023	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				HMO - Health Maintenance Organization		C	Chicago
H9525	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9525	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				HMO - Health Maintenance Organization		C	Chicago
H9525	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9564	Automated TrOOP Balance Transfer Contact	Pace, Director of finance & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	Best Available Evidence Contact	Pace, Director of Finance & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					Estenieau.jean@edenbridgehealth.org	2211 Town Center Drive SE		Wahsington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	Chief Financial Officer	Pace, Director of Finance & Compliance	Mr	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	2211 Townsend center		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	CMS Casework Communication Contact	Pace, Finance Director & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	2211 Townsend Center Drive		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	Coordination of Benefits Contact	Pace Finance Director& Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	2211 Townsend center drive SE		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	Customer Service Operations Contact	Executive Director	Mrs	Davis	Amanda		1-724-448-4129					amanda.davis@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	Government Relations Contact	Executive Director	Mr	Reiter	Thomas		1-202-810-2247					t.reiter@pace4dc.com	2211 Town Center Drive SE		Washington	DC	20020	12/07/2021	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	Medicare Compliance Officer	PACE Director of Compliance and Finance	Mr	Jean	Estenieau		1-571-622-0555					estenieau.jean@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/05/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	Part D Exceptions Contact	Pace, Director of Finance & Compliance	Mr.	Jean	Estenieau							estenieau.jean@edenbridgehealth.org	2211 Townsend center Drive SE		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending	1-000-000-0000				PACE - Nat		C	Philadelphia
H9564	Pharmacy Network Management Contact	Pace, Director of Finance & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	2211 Townsend Center Drive SE		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9564	Pharmacy Technical Help Desk Contact		Mr.	Jean	Estenieau								2211 Townsend Center Drive SE		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending	1-000-000-0000				PACE - Nat		C	Philadelphia
H9564	Plan to Plan Reconciliation Contact	Pace, Director of Finance & Compliance	Mr.	Jean	Estenieau		1-617-285-9373					estenieau.jean@edenbridgehealth.org	2211 Townsend center Drive SE		Washington	DC	20020	08/04/2022	2023	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Pending					PACE - Nat		C	Philadelphia
H9572	Automated TrOOP Balance Transfer Contact	Manager	Mr.	Nalamolu	Chandra		1-248-665-4549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Best Available Evidence Contact	Business Systems Analyst Sr		Hall	Barbara		1-313-225-6662					BHall@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	06/17/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Chief Financial Officer	Executive Vice President CFO	Mr.	Mozak	Paul	L	1-313-225-7939					PMozak@bcbsm.com	600 East Lafayette Blvd.	MC 2122	Detroit	MI	48226	01/07/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	CMS Casework Communication Contact	Business Analyst		Whitener	David		1-313-654-6885					DWhitener@bcbsm.com	1000 Town Center, Mail Code: TC1301		Southfield	MI	48075	09/08/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Coordination of Benefits Contact	Manager	Ms.	Lang	Michelle		1-248-665-4529					mlang@bcbsm.com	600 East Lafayette Blvd.	MC 1515	Detroit	MI	48226	11/16/2021	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Customer Service Operations Contact	Director	Ms.	Judson	Johanna		1-313-225-5856					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Government Relations Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Hospice Contact	Manager	Mrs.	Rawson	Lori		1-616-956-5796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/03/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Part D Exceptions Contact	Manager	Mr.	Petkoff	Ryan						1-800-459-8027	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/16/2020	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-437-3803				PPO - BBA		C	Chicago
H9572	Pharmacy Network Management Contact	Director	Mr.	Perry	Glen	A	1-313-448-5949					gperry1@bcbsm.com	600 East Lafayette Blvd.	512H	Detroit	MI	48226	06/17/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9572	Pharmacy Technical Help Desk Contact	Mgr	Mr.	Nalamolu	Chandra							hnalamolu@bcbsm.com	600 East Lafayette Blvd	MC 1309	Detroit	MI	48226	12/30/2019	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H9572	Plan to Plan Reconciliation Contact	Financial Coordinator		Jovanovska	Natasa		1-248-665-4558					njovanovska@bcbsm.com	600 East Lafayette Blvd.	Attn: P2P Mail Code 0807 -  S English	Detroit	MI	48226	06/17/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Local CCP	Blue Cross Blue Shield of Michigan	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9576	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Ms.	Sears	Michelle		1-401-427-8164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	05/11/2021	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Best Available Evidence Contact	Supervisor of Enrollment	Ms.	Garabo	Maria		1-401-459-6636					mgarabo@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	10/27/2022	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Chief Financial Officer	Chief Financial Officer	Ms.	Sears	Michelle		1-401-427-8164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	05/11/2021	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	CMS Casework Communication Contact	Sr. Manager of Quality Improvement and Accred	Ms.	Elias	Cesarina		1-401-459-6087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	10/27/2022	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Coordination of Benefits Contact	Chief Operating Officer	Ms.	Carlson	Karen		1-401-459-6633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	12/08/2021	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Customer Service Operations Contact	Manager, Member Services	Mr.	Barnett	Ronald		1-401-459-6110					rbarnett@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	06/13/2019	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Government Relations Contact	Chief Growth Officer	Mr.	Burnett	David		1-401-459-6161					dburnett@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	06/13/2019	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Hospice Contact	Interim Vice President of Pharmacy	Mr.	Lorson	Mark		1-401-459-6640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	10/27/2022	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Medicare Compliance Officer	Compliance and Privacy Officer	Mr.	Gitlitz	Gregory		1-401-459-6162					ggitlitz@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	11/16/2022	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Part D Exceptions Contact	Interim Vice President of Pharmacy	Mr.	Lorson	Mark							mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	10/27/2022	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	1-401-459-6640				Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Pharmacy Network Management Contact	Interim Vice President of Pharmacy	Mr.	Lorson	Mark		1-401-459-6640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	10/27/2022	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Pharmacy Technical Help Desk Contact			Leeper	Shonda								CVS Caremark Pharmacy Help Desk	445 Great Circle Blvd.	Nashville	TN	37228	12/13/2018	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	1-866-693-4620				Demo Risk Option C	MMP HMO Demo	C	Boston
H9576	Plan to Plan Reconciliation Contact	Manager of Financial Analysis	Mr.	Milton	Bryan		1-401-427-6726					bmilton@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	10/27/2022	2023	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Demo	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Medicare-Medicaid Plan HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Boston
H9585	Automated TrOOP Balance Transfer Contact	Director of Clinical Pharmacy		Smith	Ashley		1-617-478-3738					ashley.smith@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	06/14/2022	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Best Available Evidence Contact	Manager of Member Enrollment		Cason	Joseph		1-617-748-6356					joseph.cason@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	11/28/2016	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Chief Financial Officer	Chief Financial Officer	Mr.	Collins	James		1-617-748-6384					James.Collins@BMCHP-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	12/02/2019	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	CMS Casework Communication Contact	Director, Appeals & Grievances		Bigbee	Jacqueline		1-774-644-6922					jacqueline.bigbee@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	09/27/2022	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Coordination of Benefits Contact	Manager Of Pharmacy Operations & Contract Manager		Boyer	Nohemie		1-781-244-2649					Nohemie.Boyer@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	05/18/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Customer Service Operations Contact	Ops Mgr, Member & Provider Services		Mendez	Keyssir		1-617-748-3867					Keyssir.Mendez@BMCHP-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	11/23/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Government Relations Contact	Director of Government Affairs		Krintzman	Josh		1-617-748-6490					Josh.Krintzman@BMCHP-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	06/14/2022	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Hospice Contact	Director of Clinical Pharmacy		Smith	Ashley		1-617-478-3738					Ashley.Smith@bmchp.org	529 Main Street	Suite 500	Charlestown	MA	02129	02/11/2020	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Comerford	Michael	J	1-781-962-0405					michael.comerford@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	06/14/2022	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Part D Exceptions Contact	Director of Clinical Pharmacy		Smith	Ashley							Ashley.Smith@bmchp.org	529 Main Street	Suite 500	Charlestown	MA	02129	02/11/2020	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	1-855-833-8125				HMO - Health Maintenance Organization		C	Boston
H9585	Pharmacy Network Management Contact	Manager Of Pharmacy Operations & Contract Manager		Boyer	Nohemie		1-781-244-2649					Nohemie.Boyer@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	05/18/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9585	Pharmacy Technical Help Desk Contact	Manager Of Pharmacy Operations & Contract Manager		Boyer	Nohemie							Nohemie.Boyer@bmchp-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	12/20/2021	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Boston
H9585	Plan to Plan Reconciliation Contact	Staff Accountant		McGinnis	Kathleen		1-781-975-2780					Kathleen.McGinnis@BMCHP-wellsense.org	529 Main Street	Suite 500	Charlestown	MA	02129	04/25/2022	2023	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9589	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510				1-312-429-0194	arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	1-614-336-3326				PPO - BBA		C	Chicago
H9589	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Pharmacy Technical Help Desk Contact			Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	08/04/2021	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	1-800-922-1557				PPO - BBA		C	Chicago
H9589	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588				1-312-429-0194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9590	Automated TrOOP Balance Transfer Contact			Rush	Jamie		1-561-690-1134					ESITroopTransfer@express-scripts.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Best Available Evidence Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N 107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Chief Financial Officer		Mr.	Granow	Les		1-561-444-0709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	CMS Casework Communication Contact			Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Coordination of Benefits Contact		Ms.	Burdelik	Dawn		1-561-815-3729					dawn.burdelik@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Customer Service Operations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Government Relations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Hospice Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Medicare Compliance Officer		Ms.	Lacey	Jennifer		1-813-367-7169					Jennifer.lacey@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						1-888-235-8551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-204-0016				HMO - Health Maintenance Organization		C	New York
H9590	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		1-800-204-0016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9590	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						1-888-235-8551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H9590	Plan to Plan Reconciliation Contact		Ms.	Zhai	Vicky		1-561-632-8915					Vicky.Zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9592	Automated TrOOP Balance Transfer Contact			Shayan	Zohreh		1-949-292-5586					zshayan@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	Best Available Evidence Contact			Longoria	Daniel		1-512-507-2010					dlongoria@innovativeih.com	2042 Kern Sreet		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	Chief Financial Officer		Mr.	Longoria	Daniel		1-512-507-2010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	CMS Casework Communication Contact			Shayan	Zohreh		1-949-292-5586					zshayan@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	Coordination of Benefits Contact			Shayan	Zohreh		1-949-292-5586					zshayan@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	Customer Service Operations Contact		Ms.	Shayan	Zohreh		1-949-292-5586					zshayan@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	Government Relations Contact			Longoria	Daniel		1-512-507-2010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	Medicare Compliance Officer		Mr.	Marouf	Ghanim		1-949-394-4942					gmarouf@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	Part D Exceptions Contact			Longoria	Daniel							dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active	1-512-507-2010				PACE - Nat		C	San Francisco
H9592	Pharmacy Network Management Contact			Marouf	Ghanim		1-949-394-4942					gmarouf@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9592	Pharmacy Technical Help Desk Contact			Marouf	Ghanim							gmarouf@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active	1-949-394-4942				PACE - Nat		C	San Francisco
H9592	Plan to Plan Reconciliation Contact			Marouf	Ghanim		1-949-394-4942					gmarouf@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2023	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9614	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	02/15/2021	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/07/2021	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	02/03/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	02/03/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				PPO - BBA		C	San Francisco
H9614	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	03/31/2021	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9614	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/21/2021	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				PPO - BBA		C	San Francisco
H9614	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	02/15/2021	2023	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA, INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	San Francisco
H9615	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					wcolin@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Best Available Evidence Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		1-585-885-2361				1-585-327-2227	RMoxley@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	08/23/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Chief Financial Officer	Chief Financial Officer	Ms.	Austen	Karla		1-518-388-2357					kausten@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/26/2014	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	CMS Casework Communication Contact	Leader, Medicare Appeals		Allen	Amy		1-585-258-8096				1-585-327-5724	aallen@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	09/07/2021	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Coordination of Benefits Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					wcolin@mvphealthcare.com	220 Alexander St.		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Customer Service Operations Contact	Sr. Leader, Customer Care & Support Services		Greenberg	Melissa		1-518-991-3731					mgreenberg@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Government Relations Contact	Medicare Compliance Officer		Borges	Linda		1-518-991-3803				1-518-836-3202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Hospice Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					WColin@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Borges	Linda		1-518-991-3803				1-518-836-3202	MCO@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Part D Exceptions Contact	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	220 Alexander St.		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active	1-585-885-2435				PPO - BBA		C	New York
H9615	Pharmacy Network Management Contact	Director Network Operations		Smith	Shawn		1-480-391-4844					shawn.smith@cvshealth.com	9501 E. Shea Blvd. MC 080		Scottsdale	AZ	85260	07/18/2018	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9615	Pharmacy Technical Help Desk Contact	Director, Client Operations		Leeper	Shonda							Shonda.Leeper@CVSHealth.com	445 Great Circle Rd		Nashville	TN	37228	12/03/2021	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H9615	Plan to Plan Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		1-914-429-8496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2023	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	New York
H9616	Automated TrOOP Balance Transfer Contact	CFO	Mr.	Wallace	William	B	1-619-205-6339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	Best Available Evidence Contact	Director of Contracts	Mr.	Israel	Douglas		1-619-662-4100	4165				Disrael@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	Chief Financial Officer	CFO	Mr.	Wallace	William	B	1-619-205-6339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	CMS Casework Communication Contact	Director of Nursing	Mr.	Ballesteros	Alfredo		1-619-662-4100	3442				alfredo.ballasteros@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	Coordination of Benefits Contact	Director of Revenue Cycle	Mr.	Nubia	Charles		1-619-662-4100	4140				charles.nubia@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	Customer Service Operations Contact	Vice President of Senior Health Services	Ms.	Rodriguez	Alicia		1-619-662-4100	3483				alicia.rodriguez@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	Government Relations Contact	Vice President of External Affairs	Ms.	Melgoza	Ana		1-619-662-4100	6378				Amelgoza@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	Medicare Compliance Officer	Executive Vice President	Ms.	Dela Rosa	Veronica		1-619-662-4100	3459				veronica.delarosa@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	Part D Exceptions Contact	PACE Pharmacy Supervisor	Ms.	Park	Paula							paula.park@syhealth.org	3364 Beyer Blvd.		San Diego	CA	92173	04/14/2022	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active	1-619-662-4100	4554			PACE - Nat		C	San Francisco
H9616	Pharmacy Network Management Contact	CFO	Mr.	Wallace	William	B	1-619-205-6339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9616	Pharmacy Technical Help Desk Contact	Vice President of Senior Health Services	Ms.	Rodriguez	Alicia							alicia.rodriguez@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active	1-619-662-4100	3483			PACE - Nat		C	San Francisco
H9616	Plan to Plan Reconciliation Contact	CFO	Mr.	Wallace	William	B	1-619-205-6339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2023	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	National PACE	San Diego PACE	National PACE		Centro de Salud de la Comunidad de San Ysidro	610	Yes	Active					PACE - Nat		C	San Francisco
H9630	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H9630	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9630	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H9630	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9649	Automated TrOOP Balance Transfer Contact	Controller	Ms	Moores	Carla		1-970-255-7223					cmoores@hopewestco.org	2754 Compass Drive	Unit B	Grand Junction	CO	81506	07/26/2022	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	Best Available Evidence Contact	Controller	Ms	Moores	Carla	J	1-970-257-2372					cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	06/01/2022	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	Chief Financial Officer	Chief Financial Officer/Chief Information Officer	Ms	Walsh	Sarah		1-970-257-2414					swalsh@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	06/26/2020	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	CMS Casework Communication Contact	Director of Quality and Compliance	Ms	White	Page		1-970-263-2187	2187				pwhite@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	01/19/2022	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	Coordination of Benefits Contact	Financial Analysis Manager	Ms	Moores	Carla		1-970-257-2372	2372				cmoores@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	09/07/2021	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	Customer Service Operations Contact	Director, Quality/Compliance	Ms	White	Page		1-970-263-2187	2187				pwhite@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	09/07/2021	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	Government Relations Contact	PACE Executive Director	Ms	Orrock	Jill		1-970-255-7223					jorrock@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	03/22/2022	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	Medicare Compliance Officer	Director of Quality and Compliance	Ms	White	Page		1-970-263-2187					Pwhite@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	09/13/2021	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	Part D Exceptions Contact	Medical Director	Dr.	Dorman	Caroline							cdorman@hopewestco.org	2754 Compass Drive	Unit B	Grand Junction	CO	81506	07/26/2022	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active	1-970-255-7223				PACE - Nat		C	Dallas
H9649	Pharmacy Network Management Contact	PACE Executive Director	Ms	Orrock	Jill		1-970-255-7247	7247				jorrock@HopeWestCO.org	2754 Compass Drive		Grand Junction	CO	81506	01/19/2022	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9649	Pharmacy Technical Help Desk Contact	Sr. Dir of Clinical Services	Ms	Ripley	Amanda							aripley@HopeWestCO.org	2754 compass Drive		Grand Junction	CO	81506	01/19/2022	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active	1-866-310-8900				PACE - Nat		C	Dallas
H9649	Plan to Plan Reconciliation Contact	Controller	Ms	Moores	Carla		1-970-257-2372	2372				cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/19/2022	2023	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	Dallas
H9662	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	03/15/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O'Donnell Street		Baltimore	MD	21224	11/09/2022	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O'Donnell Street		Baltimore	MD	21224	11/09/2022	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H9662	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9662	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	02/11/2020	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H9662	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	CIGNA HEALTHCARE OF CALIFORNIA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9678	Automated TrOOP Balance Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Best Available Evidence Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Chief Financial Officer	Chief Financial Officer	Mr.	Bermel	John		1-212-479-2777					jbermel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	CMS Casework Communication Contact	Complaints Manager	Ms.	Gabriel	Charisse		1-646-767-5697					cgabriel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Coordination of Benefits Contact	Director, Payment Integrity Team	Ms.	Hutchinson	Chris		1-917-698-2415					chutchinson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Customer Service Operations Contact	VP,  Member Services	Ms.	O'Connor	Kimberly		1-212-801-1639					koconnor@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Government Relations Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		1-646-313-8967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Hospice Contact	Director, Pharmacy Operations	Ms.	Lee Brown	Hannah		1-646-429-3818					hleebrown@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Medicare Compliance Officer	Chief Compliance Officer & Head of Internal Audit	Mr.	Hackendorn	John		1-212-453-4495					jhackendorn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Part D Exceptions Contact	Director, Pharmacy Operations	Ms.	Lee Brown	Hannah							hleebrown@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active	1-888-260-1010				PPO - BBA		C	New York
H9678	Pharmacy Network Management Contact	Director, Pharmacy Operations	Mr.	Suri	Tarun		1-646-354-1168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9678	Pharmacy Technical Help Desk Contact	Director, Client Operations	Ms.	Dayoub	Joselyn							dayoubj@cvshealth.com	CVS Health	800 NW Chipman Rd, Ste 5830	Lees Summit	MO	64063	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H9678	Plan to Plan Reconciliation Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		1-646-767-5753					jhowell@healthfirst.org	100 Church Street, 18th Floor	Attn:  Treasury Department	New York	NY	10007	11/08/2022	2023	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	New York
H9686	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	08/25/2020	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/07/2021	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	San Francisco
H9686	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9686	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/21/2021	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				HMO - Health Maintenance Organization		C	San Francisco
H9686	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	02/07/2020	2023	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9699	Automated TrOOP Balance Transfer Contact	Eligibility Supervisor		White	William		1-612-777-6736					eobp2p@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	12/05/2017	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Best Available Evidence Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Chief Financial Officer	CFO	Mr.	Winter	Scott		1-501-399-3951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	CMS Casework Communication Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Coordination of Benefits Contact	Eligibility Supervisor		White	William		1-612-777-6736					cobmedd@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	12/05/2017	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Customer Service Operations Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Government Relations Contact	Sr Counsel Gov't Relation		Fenton	Janie		1-501-378-2103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/28/2019	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		1-501-378-3743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Fenske	Anjenette		1-501-244-6350					amfenske@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/10/2020	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Part D Exceptions Contact			Review Audit & Regul	Clinical						1-800-693-6703	clinicalreviewclientinquiries@primetherapeutics.co	Centennial Crossings - Clinical Review 4401 West 76th S		Edina	MN	55435	12/05/2017	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Dallas
H9699	Pharmacy Network Management Contact	Senior Director Network Provider Relations		Grindsteinner	Bretta		1-612-777-4021					bgrinsteinner@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	12/16/2015	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	Prime						1-888-285-2242	MGarzarodriguez@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	04/15/2019	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active	1-800-693-3815				HMO - Health Maintenance Organization		C	Dallas
H9699	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		1-501-399-3958				1-501-378-3258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	07/05/2019	2023	HMO PARTNERS, INC.	Local CCP	Health Advantage	HMO/HMOPOS		HMO Partners, Inc.	763	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9706	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	11/06/2020	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	02/07/2019	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	08/09/2019	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	Denver
H9706	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9706	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	1-877-277-7898				HMO - Health Maintenance Organization		C	Denver
H9706	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9712	Automated TrOOP Balance Transfer Contact	Medicare Part D Manager		Smith	Leah		1-313-664-8724					lsmith17@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	01/04/2021	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Best Available Evidence Contact	Manager, Membership & Billing		Mullins	Rhonda		1-248-443-7532					rmullins@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	04/22/2020	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Chief Financial Officer	SVP, Chief Financial Officer	Mr.	Hausenfluck	Merrill		1-248-776-3530					mhausen1@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	08/02/2022	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	CMS Casework Communication Contact	Appeals & Grievances Analyst	Ms.	Abazid	Wassan		1-313-664-8495				1-313-664-5845	wabazid@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	04/28/2021	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Coordination of Benefits Contact	VP- Claim Services		Palermo	Charles		1-248-443-8830					cpalermo@hap.org	2850 West Grand Blvd.		Detroit	MI	48202	01/03/2023	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Customer Service Operations Contact	Director	Ms	Pope	Venus		1-313-664-8933				1-313-664-8433	vpope@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	07/23/2019	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Government Relations Contact	Director, Government Programs Compliance	Mr	Randle	Johnathan		1-512-350-7810					jrandle4@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	12/17/2020	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Hospice Contact	Medicare Part D Compliance Specialist		Smith	Leah		1-313-664-8724					lsmith17@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	12/31/2018	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Medicare Compliance Officer	Director	Mr.	Randle	Johnathan		1-512-350-7810					jrandle4@hap.org	1414 E Maple		Troy	MI	48303	08/25/2022	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Part D Exceptions Contact	Medicare Part D Manager		Yaldo	Traci							tyaldo@hap.org	2850 West Grand Blvd		Detroit	MI	48202	01/04/2021	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	1-313-664-8607				Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2018	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Pharmacy Technical Help Desk Contact	Director of Customer Service		Monroe	LaTasha							latasha_monroe@express-scripts.com	13051 N. Telecom Parkway	Suite 150	Temple Terrace	FL	33637	12/14/2022	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	1-800-922-1557				Demo Risk Option C	MMP HMO Demo	C	Chicago
H9712	Plan to Plan Reconciliation Contact	Accountant II		Nasser	Zeinat		1-248-443-2076					znasser@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	04/22/2020	2023	HAP EMPOWERED HEALTH PLAN, INC.	Demo	HAP Empowered MI Health Link	Medicare-Medicaid Plan HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	Chicago
H9725	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Best Available Evidence Contact	Enrollment/Billing Senior Specialist	Ms.	Head	Ginean		1-615-234-9943					MAS.Reconciliation@healthspring.com	500 Great Circle Road		Nashville	TN	37228	03/15/2021	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	11/24/2020	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O'Donnell Street		Baltimore	MD	21224	11/09/2022	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Coordination of Benefits Contact			Holmes	Havannah		1-443-573-1984					havannah.holmes@healthspring.com	3601 O'Donnell Street		Baltimore	MD	21224	11/09/2022	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Customer Service Operations Contact	Customer Service Manager		Rich	Jared		1-615-636-4554					jared.rich@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean		1-615-234-0043					Ginean.Headd@cigna.com	500 Great Circle Rd		Nashville	TN	37228	12/15/2022	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	12/29/2021	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-480-548-0643				HMO - Health Maintenance Organization		C	New York
H9725	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H9725	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6776				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	12/29/2021	2023	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Local CCP	Cigna	HMO/HMOPOS		CIGNA	38	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9730	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H9730	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9730	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H9730	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9761	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H9761	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9761	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	1-855-538-0454				PPO - BBA		C	Dallas
H9761	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9763	Automated TrOOP Balance Transfer Contact	AVP, OHP Medical Affairs		Bayham	Alan		1-504-703-3913					alan.bayham@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	12/14/2021	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Best Available Evidence Contact			Davis	Thomas		1-570-903-4772					thomas.davis@cognizant.com	Cognizant	25 Lakeview Dr.	Jessup	PA	18434	02/15/2022	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Chief Financial Officer	Chief Financial Officer - OHP	Ms.	Blume	Lisa		1-504-354-3718					lblume@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	12/23/2021	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	CMS Casework Communication Contact	AVP, Compliance & Privacy Officer		Geter	Stefani		1-504-703-4937					stefani.geter@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	01/21/2022	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Coordination of Benefits Contact	VP, Operations		Jennings	Donna		1-678-458-9830					donna.jennings@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	01/21/2022	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Customer Service Operations Contact	VP, Operations		Jennings	Donna		1-678-458-9830					donna.jennings@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	12/01/2021	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Government Relations Contact	AVP, Compliance & Privacy Officer		Geter	Stefani		1-504-703-4937					stefani.geter@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	01/21/2022	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Hospice Contact	AVP, OHP Medical Affairs		Bayham	Alan		1-504-703-3913					alan.bayham@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	12/14/2021	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Medicare Compliance Officer	AVP, Compliance & Privacy Officer	Mrs.	Geter	Stefani		1-504-703-4937					stefani.geter@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	01/21/2022	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Part D Exceptions Contact	MedImpact Director PA & UM Programs		Emoto	Julianne							julianne.emoto@medimpact.com	MedImpact	10181 Scripps Gateway Ct.	San Diego	CA	92131	02/07/2022	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active	1-800-910-1837				HMO - Health Maintenance Organization		C	Denver
H9763	Pharmacy Network Management Contact	AVP, OHP Medical Affairs		Bayham	Alan		1-504-703-3913					alan.bayham@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	12/14/2021	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9763	Pharmacy Technical Help Desk Contact			Technical Help Desk	Pharmacy							Customerservice@Medimpact.com	MedImpact	10181 Scripps Gateway Ct.	San Diego	CA	92131	01/21/2022	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active	1-800-910-1837				HMO - Health Maintenance Organization		C	Denver
H9763	Plan to Plan Reconciliation Contact	Chief Financial Officer - OHP		Blume	Lisa		1-504-354-3718					lblume@ochsner.org	1450 Poydras St.	Suite 110	New Orleans	LA	70112	01/21/2022	2023	OCHSNER HEALTH PLAN, INC.	Local CCP	Ochsner Health Plan	HMO/HMOPOS		Ochsner Clinic Foundation	775	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9808	Automated TrOOP Balance Transfer Contact	Manager, Business Systems & Data		Rao	Chanukya		1-508-804-6892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Best Available Evidence Contact	Director of Enrollment		Felver	Steven		1-813-252-2625	7260				sfelver@beaconh.com	5415 Mariner St.	Suite 105	Tampa	FL	33609	07/06/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Chief Financial Officer	VP of Accounting and Finance	Ms.	Donoghue	Patricia		1-336-790-4386					tdonoghue@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	03/02/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	CMS Casework Communication Contact	Director of Operations		Carter	Bethany		1-336-790-4359					bcarter@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	03/02/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Coordination of Benefits Contact		Ms.	Agosto	Christina		1-813-252-2625	7142				cagosto@beaconh.com	5415 Mariner St.	Suite 105	Tampa	FL	33609	10/19/2018	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Customer Service Operations Contact	Director of Operations	Ms.	Velez	Ashley		1-888-965-1965					avelez@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	03/02/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Government Relations Contact	VP of Compliance		Tran	Triet		1-307-250-2082					ttran@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	08/09/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Hospice Contact	Chief Pharmacy Officer	Dr.	Homer	Deanna		1-336-790-4385					dhomer@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	05/21/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Medicare Compliance Officer	VP of Compliance	Mr	Tran	Triet		1-307-250-2082					ttran@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	08/09/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Part D Exceptions Contact	Manager of Pharmacy PA Operations		Chakrabarti	Swapna						1-866-871-8565	swapna.chakrabarti@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active	1-800-237-1992				PPO - BBA		C	Atlanta
H9808	Pharmacy Network Management Contact	Chief Administrative Officer		Wickremeratne	Aruna		1-508-804-6923					aruna.w@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9808	Pharmacy Technical Help Desk Contact	VP of Consumer Services		Kota	Rupa							rupa.kota@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active	1-800-237-1992				PPO - BBA		C	Atlanta
H9808	Plan to Plan Reconciliation Contact	VP of Accounting and Finance	Ms.	Donoghue	Patricia		1-336-790-4386					tdonoghue@htanc.com	7800 McCloud Road	Suite 100	Greensboro	NC	27409	03/02/2022	2023	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local PPO		Moses H. Cone Memorial Hospital Corp.	623	Yes	Active					PPO - BBA		C	Atlanta
H9811	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	11/26/2019	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H9811	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9811	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-888-865-6567				HMO - Health Maintenance Organization		C	Dallas
H9811	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	07/15/2020	2023	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare by Allwell	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Automated TrOOP Balance Transfer Contact		Mr.	Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	07/30/2020	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Best Available Evidence Contact	Director, Operations Strategy		Olatunbosun	Evelyn		1-713-295-2324				1-713-295-7041	evelyn.olatunbosun@communityhealthchoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	02/23/2021	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Chief Financial Officer	Chief Financial Officer	Mrs.	Mateja	Anna		1-713-295-2238					Anna.Mateja@communityhealthchoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	02/18/2022	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	CMS Casework Communication Contact	Director of Compliance, Regulatory		Beene	Delwin		1-713-295-2232					delwin.beene@communityhealthchoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	02/23/2021	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Coordination of Benefits Contact	Director of Claims		Dalcour	Gwendolyn		1-713-295-2384					gwendolyn.dalcour@communityhealthchoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	02/23/2021	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Customer Service Operations Contact	Sr. Director, Contact Center	Mrs.	Ziegler	Tonie		1-713-295-2235					tonie.ziegler@communityhealthchoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	09/26/2022	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Government Relations Contact	Director of Compliance, Federal Programs	Ms.	Savoy	Vernisha		1-713-314-5669					rnisha.savoy@communityhealthchoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	10/27/2022	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Hospice Contact	Pharmacy Director		Tran-Tan	Khang		1-713-295-6791					khang.tran-tan@communityhealthchoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	09/22/2020	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Medicare Compliance Officer	Director of Compliance, Federal Programs	Ms.	Savoy	Vernisha		1-713-314-5669					vernisha.savoy@communityhealthchoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	10/27/2022	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Part D Exceptions Contact			LeClair	Chris						1-920-221-4676	christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	07/30/2020	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Dallas
H9826	Pharmacy Network Management Contact	Associate Director, Pharmacy Network		Burdick	Tammy	~	1-920-221-4089				1-920-221-4589	tammy.burdick@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	07/30/2020	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9826	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/16/2022	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Dallas
H9826	Plan to Plan Reconciliation Contact	Controller	Mrs.	Nguyen	Sue		1-713-295-2238					Sue.Nguyen@CommunityHealthChoice.org	2636 South Loop West	Suite 125	Houston	TX	77054	09/26/2022	2023	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9827	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		1-614-546-3183				1-614-546-3131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		1-614-546-3222				1-614-546-3148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		1-614-546-3211				1-614-546-3131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	CMS Casework Communication Contact	Compliance Specialist	Mr.	Jordan	David	A	1-614-706-8474				1-614-234-8372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Customer Service Operations Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		1-614-546-3180				1-614-546-3132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Government Relations Contact	CEO	Mr	Randolph	John	C	1-614-546-3152				1-614-546-3131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		1-412-478-0244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Exceptions Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	1-800-240-3851				HMO - Health Maintenance Organization		C	Chicago
H9827	Pharmacy Network Management Contact	Director, Pharmacy	Mr	Turoff	Chris		1-614-403-0394					chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Mr	Turoff	Chris							chris.turoff@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Chicago
H9827	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		1-614-546-3183				1-614-546-3132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2023	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Automated TrOOP Balance Transfer Contact	Medicare Part D Program Manager		Zlotkus	Steve		1-858-790-6250					partdcat@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/24/2021	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Best Available Evidence Contact	Manager of Medicare Operations		McMillan	Kyle		1-313-580-6282					kyle.mcmillan@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	11/10/2021	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Chief Financial Officer	Chief Financial Officer	Mr.	Agnone	Matthew		1-313-510-7361					matthew.agnone@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	12/01/2020	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	CMS Casework Communication Contact	Director of Medicare Operations		Buchko	Morgan		1-734-934-9490					morgan.buchko@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	12/01/2020	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Coordination of Benefits Contact	Manager of Medicare Operations		McMillan	Kyle		1-313-580-6282					kyle.mcmillan@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	11/10/2021	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Customer Service Operations Contact	Manager of Concierge Services		Wolan	Elizabeth		1-313-445-8677					elizabeth.wolan@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	12/01/2020	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Government Relations Contact	Vice President of Legal Affairs		Muzingo	Joseph		1-313-617-7323					joseph.muzingo@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	06/13/2022	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Hospice Contact	Director of Medicare Operations		Buchko	Morgan		1-734-934-9490					morgan.buchko@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	12/01/2020	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Medicare Compliance Officer	Manager of Medicare Compliance	Mr.	Martin	Nate		1-313-283-2346					nate.martin@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	11/19/2021	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Part D Exceptions Contact			Spencer	Stephanie							stephanie.spencer@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	06/13/2022	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active	1-844-279-0508	1002			HMO - Health Maintenance Organization		C	Chicago
H9828	Pharmacy Network Management Contact	Chief Development Officer		Pitera	Raymond		1-248-763-3252					raymond.pitera@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	12/01/2020	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9828	Pharmacy Technical Help Desk Contact	VP, Contact Center Services		Battle	Dorry							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	09/02/2021	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active	1-888-495-3102				HMO - Health Maintenance Organization		C	Chicago
H9828	Plan to Plan Reconciliation Contact	Director of Finance & Accounting		Dobrovolschi	Natalia		1-734-306-0443					natalia.dobrovolschi@apexhealth.com	96 Kercheval Avenue	Suite 200	Grosse Pointe Farms	MI	48236	04/21/2022	2023	APEX HEALTH, INC.	Local CCP	ApexHealth	HMO/HMOPOS		J.B. Cotton & Company, LLC	729	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9830	Automated TrOOP Balance Transfer Contact	Director, PACE Finance	Ms	Hewitt	Jessica		1-303-869-4664				1-303-996-1600	jhewitt@myinnovage.com	8950 E Lowry Blvd		Denver	CO	80230	09/29/2021	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Best Available Evidence Contact	Finance and Compliance Analyst	Mr.	Kizewski	Alex		1-303-869-4664				1-303-996-1600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/17/2021	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Chief Financial Officer	CFO	Ms.	Gutierrez	Barbara		1-303-869-4664				1-303-996-1600	bgutierriz@myinnovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	10/11/2018	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	CMS Casework Communication Contact	Corporate Director of Compliance		Peak	Elizabeth		1-804-543-0876				1-303-996-1600	epeak@myinnovage.com	750 E 6th St		Richmond	VA	23224	10/01/2021	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		1-303-869-4664				1-303-996-1600	lbrown2@myinnovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	07/09/2020	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Customer Service Operations Contact	Regional Executive Director	Mr.	Champeaux	Jarod		1-267-624-8510				1-215-951-4316	JChampeaux@myinnovage.com	6970 Germantown Avenue		Philadelphia	PA	19119	04/26/2022	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Government Relations Contact	Executive VP Government Relations		Steckel	Carol		1-720-789-6157				1-303-996-1600	CSteckel@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/26/2022	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Medicare Compliance Officer	VP of Pharmacy Services	Ms.	Chase	Darla		1-720-974-6785				1-303-996-1614	dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	04/24/2020	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Part D Exceptions Contact	VP of Pharmacy Services	Ms.	Chase	Darla							dchase@myinnovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	04/24/2020	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Philadelphia
H9830	Pharmacy Network Management Contact	VP of Pharmacy Services	Ms.	Chase	Darla		1-720-974-6785					dchase@myinnovage.com	8950 East Lowry	5457 Wayne Avenue	Denver	CO	80230	04/24/2020	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Pharmacy Technical Help Desk Contact	VP of Pharmacy Services	Ms.	Chase	Darla							dchase@myinnovage.com	8950 East Lowry Blvd		Denver	CO	80230	09/29/2021	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active	1-720-974-6785				PACE - Nat		C	Philadelphia
H9830	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		1-303-869-4664				1-720-917-3390	AKizewski@myinnovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80203	09/29/2021	2023	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9834	Automated TrOOP Balance Transfer Contact	Pharmacy Manager		Suhr	Anessa		1-608-881-8616				1-608-881-8307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Best Available Evidence Contact	Director of Enrollment		Krueger	Cindy		1-608-471-4900					cindy.krueger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Chief Financial Officer	Vice President, CFO, Treasurer	Mr.	Hiveley	Jim		1-608-821-1081					james.hiveley@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	CMS Casework Communication Contact	Compliance Analyst		Stanton	Jessica		1-608-881-8157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Coordination of Benefits Contact	Director of Enrollment		Krueger	Cindy		1-608-471-4900					cindy.krueger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Customer Service Operations Contact	Senior Director of Customer Success		Greubel	Lori		1-608-644-1433					lori.greubel@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Government Relations Contact	Assistant Vice President Compliance & Government	Mrs.	Skifton	Kelly		1-608-881-8151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Hospice Contact	Pharmacy Manager		Suhr	Anessa		1-608-881-8616				1-608-881-8307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Medicare Compliance Officer	Assistant Vice President Compliance & Government	Ms.	Skifton	Kelly	N	1-608-881-8151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Exceptions Contact	Pharmacy Manager		Suhr	Anessa						1-608-881-8307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	1-800-394-5566				HMO - Health Maintenance Organization		C	Chicago
H9834	Pharmacy Network Management Contact	Pharmacy Manager		Suhr	Anessa		1-608-881-8616				1-608-881-8307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Pharmacy Technical Help Desk Contact	Quartz Medicare Advantage Part D Help Desk		Medicare Advantage	Quartz							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/06/2020	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	1-888-728-4689				HMO - Health Maintenance Organization		C	Chicago
H9834	Plan to Plan Reconciliation Contact	Accountant		Cheung	Sheila		1-608-881-8082					sheila.cheung@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	12/13/2022	2023	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9842	Automated TrOOP Balance Transfer Contact	Regional Finance Director		Fuhrmeister	Nicole		1-215-778-8707					nicole.fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	10/03/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Best Available Evidence Contact	Regional Finance Director		Fuhrmeister	Nicole		1-215-778-8707					nicole.fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	10/03/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Chief Financial Officer	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	10/03/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	CMS Casework Communication Contact	Director Quality & Compliance	Ms.	Anastasio	Michelle		1-574-247-8717					mailto:Michelle.Anastasio@Trinity-Health.org	250 E. Day Rd		Mishawaka	IN	46545	10/03/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Coordination of Benefits Contact	Regional Finance Director		Fuhrmeister	Nicole		1-215-778-8707					nicole.fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	10/03/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Customer Service Operations Contact	Executive Director	Ms	Huegel	Lori Anne		1-574-247-8763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/17/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Government Relations Contact	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	10/03/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Medicare Compliance Officer	Chief Clinical & Compliance Officer	Ms	Hays McElroy	Carrie		1-734-343-2668					carrie.haysmcelroy@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	09/22/2020	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Part D Exceptions Contact	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	01/04/2021	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active	1-215-339-4362				PACE - Nat		C	Chicago
H9842	Pharmacy Network Management Contact	Manager Pharmacy, Part D Compliance		Garbarino	Joseph		1-215-339-4362					joseph.garbarino@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	10/03/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Pharmacy Technical Help Desk Contact			Tanner	B.							btanner@pharmastarpbm.com	Pharmastar LLC	P.O. Box 3217	Eau Claire	WI	54702	12/07/2015	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active	1-888-298-7770				PACE - Nat		C	Chicago
H9842	Plan to Plan Reconciliation Contact	Regional Finance Director		Fuhrmeister	Nicole		1-215-778-8707					nicole.fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	10/03/2022	2023	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9861	Automated TrOOP Balance Transfer Contact	General Manager		Keane	Brian		1-248-715-5410					bkeane@commonwealthcare.org	23900 Orchard Lake Rd.	Suite 210	Farmington Hills	MI	48336	12/31/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Best Available Evidence Contact	Director, Enrollment, Recon. & Retention		Andrade	Remo		1-617-426-0600	57931				randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/12/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Chief Financial Officer	Chief Financial Officer	Ms.	Hamilton	Mary		1-857-327-1953					mahamilton@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	CMS Casework Communication Contact	Director, Appeals & Grievances	Mr.	Schenk	Tyrone		1-857-327-3320					tschenk@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/12/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Coordination of Benefits Contact	Director, Enrollment, Recon. & Retention		Andrade	Remo		1-617-426-0600	57931				randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/12/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Customer Service Operations Contact	VP Operations		Habib	Fred		1-617-426-0600	1504				fhabib@commonwealthcare.org	2 Avenue de Lafayette		Boston	MA	02111	12/13/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Government Relations Contact	VP, Government Relations		Preede	Ken		1-617-426-0600					kpreede@commonwealthcare.org	30 Winter St		Boston	MA	02108	09/20/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Hospice Contact	Medical Director	Dr.	Berger	Gregory		1-313-971-5547					gberger@commonwealthcare.org	23900 Orchard Lake Rd.	Suite 210	Farmington Hills	MI	48336	10/04/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	Lavallee	Katherine		1-617-947-5780					KLavalee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/01/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Part D Exceptions Contact			Mourad	Hala							Hala.Mourad@optum.com	2441 Warrenville Rd		Lisle	IL	60532	02/13/2019	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-630-328-5837				HMO - Health Maintenance Organization		C	Boston
H9861	Pharmacy Network Management Contact			Pham	Katie		1-817-846-9722					Katie.Pham@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	02/13/2019	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9861	Pharmacy Technical Help Desk Contact			Summers	Todd							Todd.Summers@optum.com	755 Research Pkwy		Oklahoma City	OK	73104	02/13/2019	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-443-1095				HMO - Health Maintenance Organization		C	Boston
H9861	Plan to Plan Reconciliation Contact	Accounts Receivable Coordinator		Newman	Elaine		1-617-426-0600	52580				enewman@commonwealthcare.org	30 Winter St		Boston	MA	02108	08/25/2022	2023	CCA HEALTH MICHIGAN, INC.	Local CCP	CCA Health Michigan	HMO/HMOPOS		Commonwealth Care Alliance, Inc.	60	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H9869	Automated TrOOP Balance Transfer Contact	Manager, Vendor Oversight & Special Projects		Carroccia	Kimberly		1-646-883-9034				1-646-892-4810	kcarroccia@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Best Available Evidence Contact	Chief Compliance Officer	Ms.	john	Lisa		1-518-949-6627					ljohn@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Chief Financial Officer	Chief Financial Officer	Mr.	Masi	Chris		1-646-771-9967					cmasi@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	CMS Casework Communication Contact	Chief Administrative Officer	Ms.	O'Connor	Megan		1-646-883-9908					dmarrone@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Coordination of Benefits Contact	Chief Compliance Officer	Ms.	John	Lisa		1-518-949-6627					ljohn@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Customer Service Operations Contact	Chief Compliance Officer	Ms.	John	Lisa		1-518-949-6627					ljohn@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Government Relations Contact	Chief Compliance Officer	Ms.	John	Lisa		1-518-949-6627					ljohn@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Hospice Contact	Chief Compliance Officer	Ms	John	Lisa		1-518-949-6627					ljohn@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Medicare Compliance Officer	Chief Compliance Officer	Ms.	John	Lisa		1-518-949-6627					ljohn@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Part D Exceptions Contact	Manager, Vendor Oversight & Special Projects		Carroccia	Kimberly						1-646-892-4810	kcarroccia@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active	1-646-883-9034				Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Pharmacy Network Management Contact	Director Configuration Services		Dunnum	Shawn		1-858-790-7454				1-215-863-5100	Shawndunnum@MedImpact.com	10181 Scripps Gateway Ct.	10181 Scripps Gateway CT.	San Diego	CA	92131	12/17/2020	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Pharmacy Technical Help Desk Contact	VP, Contact Center Services		Battle	Dorry							CustomerService@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/17/2020	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active	1-888-648-6759				Demo Risk Option C	MMP HMO Demo	C	New York
H9869	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Masi	Chris		1-646-883-4171					cmasi@phpcares.org	2500 Halsey Street		Bronx	NY	10461	01/24/2022	2023	PARTNERS HEALTH PLAN, INC.	Demo	Partners Health Plan	Medicare-Medicaid Plan HMO/HMOPOS		PHSI, Inc.	595	Yes	Active					Demo Risk Option C	MMP HMO Demo	C	New York
H9876	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment and Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Best Available Evidence Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931				randrade@commonwealthcare.org	30 Winter St		Boston	MA	02108	02/05/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Chief Financial Officer	Chief Financial Officer	Ms.	Hamilton	Mary		1-857-327-1953					mahamilton@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	CMS Casework Communication Contact	Director, Appeals& Grievances		Schenk	Tyrone		1-857-327-3320				1-857-453-4517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Coordination of Benefits Contact	Director. Enrollment & Retention		Andrade	Remo		1-617-426-0600	7931			1-617-426-3109	randrade@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/05/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Customer Service Operations Contact	VP, Customer Service		Habib	Fred		1-617-426-0600	1504			1-617-426-3097	fhabib@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/21/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Government Relations Contact	VP, Government Relations		Preede	Ken		1-617-426-0600	51412				kpreede@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/30/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Hospice Contact	Palliative Care Medical Director		Ragland	Julia		1-781-525-4203					jragland@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	10/04/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Medicare Compliance Officer	Director, Medicare Compliance Officer	Ms.	Lavallee	Katherine		1-617-947-5780					KLavalee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/01/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Part D Exceptions Contact	Sr. Manager, Clinical Prior Auth		LeClair	Christophe						1-920-221-4676	Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/25/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877				PPO - BBA		C	Boston
H9876	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@Navitus.com	361 Integrity Drive		Madison	WI	53713	03/25/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9876	Pharmacy Technical Help Desk Contact	Sr. Mgr, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	53713	03/25/2021	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active	1-866-270-3877	4224			PPO - BBA		C	Boston
H9876	Plan to Plan Reconciliation Contact	Accounts Receivable Coordinator		Newman	Elaine		1-617-426-0600	52580				enewman@commonwealthcare.org	30 Winter St		Boston	MA	02108	08/25/2022	2023	Commonwealth Care Alliance Rhode Island, LLC	Local CCP	CCA Health Rhode Island	Local PPO		Commonwealth Care Alliance, Inc.	60	Yes	Active					PPO - BBA		C	Boston
H9877	Automated TrOOP Balance Transfer Contact	Director of Pharmacy Ops & Compliance		May	Crystal		1-804-687-8378				1-757-692-5575	RxBenefits@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Best Available Evidence Contact	Director Enrollment & Disenrollment		Brown	Sheila		1-757-252-8015				1-757-692-5575	sxbrown29@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Chief Financial Officer	Director Medicare Finance	Ms.	Eagleson	Leigh		1-443-851-6654				1-757-552-7396	laeagles@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	CMS Casework Communication Contact	Manager Regulatory Compliance		Monroe	Latasha		1-804-721-7037					lajones4@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Coordination of Benefits Contact	Direct Ops Support		Driskill	Kenneth		1-804-819-5151				1-757-687-6231	kwdriski@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Customer Service Operations Contact	Director, Customer Services		Brogan	Kim		1-757-434-9999				1-757-552-7116	krbrogan@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Government Relations Contact	Director Government Programs - Medicare		Hoffman	Daniel		1-757-983-2540				1-757-552-7396	dehoffma@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Hospice Contact	Manager Pharmacy Benefits	Ms.	Strickland	Brandi		1-757-252-8193					RxBenefits@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Green	Janet		1-813-368-2227					JLGREE13@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Part D Exceptions Contact	Clinical Pharmacist Medicare		Papcun	Richard							rfpapcu1@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	1-804-816-5151	55006			HMO - Health Maintenance Organization		C	Philadelphia
H9877	Pharmacy Network Management Contact	VP, Pharmacy		Daw	Jessica		1-757-252-8181				1-757-962-5575	jrdaw@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9877	Pharmacy Technical Help Desk Contact			Solutions	Elixir								2181 East Aurora Rd Suite 201, Twinsburg, OH 44087		Twinsburg	OH	44087	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	1-855-408-0010				HMO - Health Maintenance Organization		C	Philadelphia
H9877	Plan to Plan Reconciliation Contact	Accounting Manager		Duncan	April		1-757-252-8055				1-757-252-8030	acmorgan@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	VIRGINIA PREMIER HEALTH PLAN, INC.	Local CCP	Virginia Premier	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9884	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H9884	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9884	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H9884	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Best Available Evidence Contact	Manager of Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	Bradley		1-781-810-8450					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	CMS Casework Communication Contact	Director of Appeals and Grievances		Cagot	Janette		1-304-914-6913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Coordination of Benefits Contact	Manager Membership Operations		Ewing	David		1-619-884-4822					dewing@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Customer Service Operations Contact	Chief Member Experience Officer		Nanavati	Monna		1-339-203-7312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Government Relations Contact	Chief Legal and External Affairs Office		Cowan	Mo		1-617-407-8110					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Hospice Contact	Manager Enrollment Operations		Mangat	Sunny		1-617-858-9484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		1-267-530-4834					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Part D Exceptions Contact	Part D Operations		Fallas	Cynthia							Cfallas@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-508-954-1716				PPO - BBA		C	New York
H9888	Pharmacy Network Management Contact	Director of Part D Operations		Stearns	David		1-207-239-8200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9888	Pharmacy Technical Help Desk Contact	Director of Part D Operations		Stearns	David							DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	1-866-693-4620				PPO - BBA		C	New York
H9888	Plan to Plan Reconciliation Contact	Assistant Controller		Tran	Jessica		1-617-513-1910					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	12/14/2022	2023	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9900	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	06/14/2022	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/14/2022	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	06/14/2022	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-813-206-7152				HMO - Health Maintenance Organization		C	Dallas
H9900	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9900	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/02/2021	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	1-855-538-0454				HMO - Health Maintenance Organization		C	Dallas
H9900	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/02/2021	2023	WELLCARE OF OKLAHOMA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9904	Automated TrOOP Balance Transfer Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	01/31/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Best Available Evidence Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	01/31/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Chief Financial Officer	Chief Financial Officer	Mr.	James	Beermann		1-774-701-1437					james.beermann@massadvantage.com	365 Plantation St	3rd Floor	Worcester	MA	01605	01/10/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	CMS Casework Communication Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Coordination of Benefits Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Customer Service Operations Contact	Vice President		Velten	Steve		1-816-435-7408					svelten@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	06/08/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Government Relations Contact	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	08/26/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Hospice Contact	Vice President		Velten	Steve		1-816-435-7408					svelten@dsthealth.com	210 W 10th St		Kansas City	MO	64105	06/08/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Perritt	Maggie		1-774-701-1604					maggie.perritt@massadvantage.com	365 Plantation Street	3rd floor	Worcester	MA	01605	11/11/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Part D Exceptions Contact	Vice President, Compliance & Contracting		Cone	Mark							mark.cone@sscinc.com	210 W. 10th Street		Kansas City	MO	64105	04/09/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active	1-816-843-6461				PPO - BBA		C	New York
H9904	Pharmacy Network Management Contact	Sr Director Pharmacy Network Analytics and Pricing		Huffman	Greg		1-816-435-2471					ghuffman@sscinc.com	210 W 10th St		Kansas City	MO	64105	10/18/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9904	Pharmacy Technical Help Desk Contact	Sr Director Pharmacy Network Analytics and Pricing		Huffman	Greg							ghuffman@sscinc.com	210 W 10th St		Kansas City	MO	64105	10/24/2022	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active	1-844-915-0234				PPO - BBA		C	New York
H9904	Plan to Plan Reconciliation Contact	Vice President, Compliance & Contracting		Cone	Mark		1-816-843-6461					mark.cone@sscinc.com	210 W. 10th Street		Kansas City	MO	64105	04/09/2021	2023	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	New York
H9907	Automated TrOOP Balance Transfer Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Best Available Evidence Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Chief Financial Officer	SVP Chief Financial Officer	Mr.	Kurpad	Umesh		1-781-612-1000	84968				umesh.kurpad@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	CMS Casework Communication Contact	Director, Appeals & Grievances	Ms.	Evans	Kathleen		1-617-972-9400	87204				kathleen.evans@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Coordination of Benefits Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Customer Service Operations Contact	Manager, Member Services	Ms.	Villatoro	Yesly		1-781-612-1000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Government Relations Contact	Chief Government Affairs Officer	Ms.	Lewis	Kristin		1-781-612-1000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Hospice Contact	Manager, Pharmacy Operations & Programs	Ms.	MacAuley	Jacqueline		1-781-612-1000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Taylor	James		1-781-612-1000	88089				james.taylor@point32health.org	1 Wellness Way		Canton	MA	02021	01/04/2023	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active	1-781-612-1000	82370			PPO - BBA		C	Boston
H9907	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/09/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	12/08/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active	1-855-524-0380				PPO - BBA		C	Boston
H9907	Plan to Plan Reconciliation Contact	Manager, Finance Operations	Ms.	Olson	Rachel		1-781-612-1000	84360				rachel.olson@point32health.org	1 Wellness Way		Canton	MA	02021	02/04/2022	2023	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9909	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Chief Financial Officer	Vice President, Finance	Mr.	Harris	Richard		1-713-557-5987				1-844-280-5360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		1-615-465-0182				1-844-280-5360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Customer Service Operations Contact	Director, Health Plan Administration	Ms.	Bridgeforth	Jennifer		1-615-905-5424				1-844-280-5360	jbridgeforth@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/18/2020	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		1-405-601-2482				1-844-280-5360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		1-405-404-6691				1-844-280-5360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						1-330-486-4801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-330-888-6079				HMO - Health Maintenance Organization		C	Dallas
H9909	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		1-330-486-4864				1-330-405-8094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9909	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	09/07/2021	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	1-833-661-1993				HMO - Health Maintenance Organization		C	Dallas
H9909	Plan to Plan Reconciliation Contact	Manager,  Accounting & Statutory Reporting	Ms.	O'Brien	Tammy		1-615-656-3654	240			1-615-614-8425	tobrien@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2023	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9917	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/10/2020	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Best Available Evidence Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/10/2020	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Chief Financial Officer	CFO	Mr.	Ragland	Robert		1-804-366-3300					Robert.Ragland@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		1-786-239-8513					Erik.Fernandez@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Coordination of Benefits Contact			Lowry	Kristy		1-804-332-5119					kristy.lowry@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/10/2020	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Customer Service Operations Contact			Davis	Damon		1-804-332-5134					damon.davis@allyalign.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	12/23/2021	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Government Relations Contact			Landahl	Darryl		1-832-384-5949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		1-347-683-5717					victor.sone@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	12/23/2021	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		1-615-481-1897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	08/10/2022	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Part D Exceptions Contact			LeClair	Christophe						1-920-221-4676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	12/23/2021	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-920-221-4176				HMO - Health Maintenance Organization		C	Philadelphia
H9917	Pharmacy Network Management Contact			Robinson	Jan		1-608-729-1688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	12/23/2021	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9917	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/10/2020	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active	1-866-270-3877	4224			HMO - Health Maintenance Organization		C	Philadelphia
H9917	Plan to Plan Reconciliation Contact	Chief Operating Officer	Mr.	Dressen	Jeremy		1-612-747-4241					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/16/2022	2023	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Innovative Long Term Care Management, Inc.	733	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H9940	Automated TrOOP Balance Transfer Contact			Rush	Jamie		1-561-690-1134					ESITroopTransfer@express-scripts.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Best Available Evidence Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N 107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Chief Financial Officer		Mr.	Granow	Les		1-561-444-0709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	CMS Casework Communication Contact			Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Coordination of Benefits Contact		Ms.	Burdelik	Dawn		1-561-815-3729					dawn.burdelik@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Customer Service Operations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Government Relations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Hospice Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Medicare Compliance Officer		Ms.	Lacey	Jennifer		1-813-367-7169					Jennifer.lacey@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						1-888-235-8551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-204-0016				HMO - Health Maintenance Organization		C	New York
H9940	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		1-800-204-0016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9940	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						1-888-235-8551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	New York
H9940	Plan to Plan Reconciliation Contact		Ms.	Zhai	Vicky		1-561-632-8915					Vicky.Zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF MASSACHUSETTS INC	Local CCP	Longevity Health Plan of Massachusetts	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9942	Automated TrOOP Balance Transfer Contact			Rush	Jamie		1-561-690-1134					ESITroopTransfer@express-scripts.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Best Available Evidence Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N 107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Chief Financial Officer		Mr.	Granow	Les		1-561-444-0709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	CMS Casework Communication Contact			Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Coordination of Benefits Contact		Ms.	Burdelik	Dawn		1-561-815-3729					dawn.burdelik@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Customer Service Operations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Government Relations Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Hospice Contact	Medicare Compliance Director	Ms.	Socoski	Beth		1-561-690-1134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Medicare Compliance Officer		Ms.	Lacey	Jennifer		1-813-367-7169					Jennifer.lacey@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						1-888-235-8551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active	1-800-204-0016				PPO - BBA		C	New York
H9942	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		1-800-204-0016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9942	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						1-888-235-8551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active	1-800-922-1557				PPO - BBA		C	New York
H9942	Plan to Plan Reconciliation Contact		Ms.	Zhai	Vicky		1-561-632-8915					Vicky.Zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2023	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active					PPO - BBA		C	New York
H9943	Automated TrOOP Balance Transfer Contact	PBM - Manager, PBM Operations		Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Best Available Evidence Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-562-207-4509				1-562-207-4623	CArreola@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Chief Financial Officer	Chief Financial Officer	Mr.	Freeman	Thomas		1-913-488-0148					TFreeman@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	CMS Casework Communication Contact	CEO		Maroney	Dawn		1-562-334-6192				1-844-320-2247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	06/03/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Coordination of Benefits Contact	AVP, Membership & Eligibility		Arreola	Carrie		1-657-218-7409	2109				CArreola@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		1-562-207-4530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Government Relations Contact	VP, Chief Compliance Officer		Lynch	Cindy		1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		1-657-218-7709				1-562-207-4630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Medicare Compliance Officer	VP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	1-657-383-5394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Part D Exceptions Contact	PBM - Director, Regulatory and Audit Response		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/03/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-800-693-6651				HMO - Health Maintenance Organization		C	San Francisco
H9943	Pharmacy Network Management Contact	PBM - AVP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9943	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	1-855-457-0622				HMO - Health Maintenance Organization		C	San Francisco
H9943	Plan to Plan Reconciliation Contact	Sr. Financial Analyst		De La Torre	Angelo		1-323-728-7232	2122			1-562-207-4266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	92868-4600	01/20/2022	2023	ALIGNMENT HEALTH PLAN OF FLORIDA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H9952	Automated TrOOP Balance Transfer Contact			Bean	Danielle		1-952-992-2864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Best Available Evidence Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Chief Financial Officer		Ms	Quist	Mary		1-952-992-2058					mary.quist@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	CMS Casework Communication Contact			Sikorski	TJ		1-952-992-8542				1-952-992-8492	thomas.sikorski@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/04/2023	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Coordination of Benefits Contact			Vilendrer	Krista		1-952-992-3252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Customer Service Operations Contact			Bock	Kelly		1-952-992-8379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Government Relations Contact			Kinsella	Ann		1-952-992-3832					ann.kinsella@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/21/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Hospice Contact			Bourdages	Kathy		1-952-992-3653				1-952-992-3636	PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/13/2018	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Medicare Compliance Officer		Mrs	Koranteng	Milly		1-952-992-2090					mildred.koranteng@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/22/2020	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/13/2018	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-952-992-2353				HMO - Health Maintenance Organization		C	Kansas City
H9952	Pharmacy Network Management Contact			Dornbrook-Lavender	Kimberly		1-952-992-3448					kimberly.dornbrook-lavender@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9952	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	La Tasha							LaTasha_Monroe@expressscripts.com	13051 N. Telecom Pkwy		Temple Terrace	FL	33637	11/17/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	1-800-922-1557				HMO - Health Maintenance Organization		C	Kansas City
H9952	Plan to Plan Reconciliation Contact			Cameron	Andrew		1-952-992-2386					Andrew.Cameron@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	11/12/2021	2023	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9955	Automated TrOOP Balance Transfer Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Best Available Evidence Contact	AVP, Medicare Enrollment		Thorpe	Melissa		1-562-542-2116					Melissa.Thorpe@molinahealthcare.com	604 Pine Ave		Long Beach	CA	90802	04/05/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Chief Financial Officer	CFO, Medicare	Mr.	Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	CMS Casework Communication Contact	Vice President, Medicare Operations		Woodruff	Staci-Ann		1-860-806-0065					staci-ann.woodruff@molinahealthcare.com	762 Charlestown Rd.		Acworth	NH	03601	01/21/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		1-484-269-1480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Customer Service Operations Contact	Vice President, Core Operations		Ireland	Scott		1-562-380-2252					Scott.Ireland@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/13/2021	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Hospice Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		1-562-951-1594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Part D Exceptions Contact	Director, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-801-252-5706				HMO - Health Maintenance Organization		C	New York
H9955	Pharmacy Network Management Contact	Director, Medicare Pharmacy Services		Vu	John		1-801-252-5706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	12/06/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9955	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						1-480-314-6077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	New York
H9955	Plan to Plan Reconciliation Contact	CFO, Medicare		Wilson	David		1-562-951-1568					David.S.Wilson@MolinaHealthCare.Com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2023	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.,	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9959	Automated TrOOP Balance Transfer Contact	Regional Director of Operations		Hulon	Amber		1-727-417-5819					Ahulon@kinshiphs.com	430 SW 27th Ave, Apt 409		Ft. Lauderdale	FL	33312	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	Best Available Evidence Contact	Executive Assistant		Anderson	Brooke		1-559-960-5671					BAnderson@kinshiphs.com	1099 Sylmar Ave Apt 203		Clovis	CA	93612	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	Chief Financial Officer	CEO	Mr	Enderle	John		1-860-655-9211					jenderle@kinshiphs.com	31 Andreis Trail		South Windsor	CT	06074	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	CMS Casework Communication Contact	Regional Director of Operations		Hulon	Amber		1-727-417-5819					Ahulon@kinshiphs.com	430 SW 27th Ave, Apt 409		Ft. Lauderdale	FL	33312	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	Coordination of Benefits Contact	Regional Director of Operations		Hulon	Amber		1-727-417-5819					Ahulon@kinshiphs.com	430 SW 27th Ave, Apt 409		Ft. Lauderdale	FL	33312	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	Customer Service Operations Contact	Director of Operations and Implementation	Mr.	Beijer	David		1-828-702-9191					dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	Government Relations Contact	Chief Strategy Officer	Ms.	Kohn	Judy		1-917-270-0599					jkohn@kinshiphs.com	260 Pearsall place		Lawrence	NY	11559	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	Medicare Compliance Officer	Director of Operations and Implementation	Mr	Beijer	David		1-828-702-9191					dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	Part D Exceptions Contact	Regional Director of Operations	Ms	Hulon	Amber						1-559-238-9224	Ahulon@kinshiphs.com	430 SW 27th Ave, Apt 409		Ft. Lauderdale	FL	33312	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending	1-800-639-1305				PACE - Nat		C	Atlanta
H9959	Pharmacy Network Management Contact	Director of Operations and Implementation	Mr	Beijer	David		1-828-702-9191					dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9959	Pharmacy Technical Help Desk Contact	Director of Operations and Implementation	Mr.	Beijer	David						1-559-238-9224	dbeijer@kinshiphs.com	14 Berry Lane		Fletcher	NC	28732	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending	1-800-639-1305				PACE - Nat		C	Atlanta
H9959	Plan to Plan Reconciliation Contact	Executive Assistant		Anderson	Brooke		1-559-960-5671					BAnderson@kinshiphs.com	1099 Sylmar Ave Apt 203		Clovis	CA	93612	03/22/2022	2023	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H9976	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Best Available Evidence Contact	Manager, Membership & Accounting		Starks	Heather		1-818-676-6477					heather.b.starks@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	03/11/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Chief Financial Officer	Regional VP, CFO Products	Mr.	Leaf	Garrett		1-916-891-3880					Garrett.M.Leaf@centene.com	4191 E Commerce Way building A	4th Floor	Sacramento	CA	95834	06/15/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	CMS Casework Communication Contact	Manager, Grievance & Appeals	Ms	McCline	Keshia		1-314-484-6350					RhodeKeshia.Q.McCline@centene.com	7676 Forsyth Blvd.		Clayton	MO	63105	06/09/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		1-314-349-3212					cob@centene.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Customer Service Operations Contact	Director, Call Center Operations	Mr.	Vargus	Tom		1-480-587-4894					tom.vargus@centene.com	1665 West Alameda Drive	Ste 110	Tempe	AZ	85282	01/27/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	06/09/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active	1-813-206-7152				PPO - BBA		C	Dallas
H9976	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/11/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9976	Pharmacy Technical Help Desk Contact	VP, Contact Centers		Bollent	Jason							Jason.Bollent@wellcare.com	5519 Idlewild Avenue		Tampa	FL	33634	03/26/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active	1-888-865-6567				PPO - BBA		C	Dallas
H9976	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	01/27/2021	2023	WESTERN SKY COMMUNITY CARE, INC.	Local CCP	Wellcare by Allwell	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Dallas
H9986	Automated TrOOP Balance Transfer Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		1-786-679-6899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Best Available Evidence Contact	Sr. VP of Operations		Gutwald	David		1-631-881-2404	801304				dgutwald@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	02/09/2021	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Chief Financial Officer	CFO	Mr	Thomas	Tarlton		1-305-262-1292	106643				tthomas@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	01/04/2023	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	CMS Casework Communication Contact	Senior Director of Medicare Operations		Fagundo	Jenny		1-786-543-5229					JFagundo@ilshealth.com	4601 N.W. 77th Avenue		Miami	FL	33166	12/02/2022	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Coordination of Benefits Contact	Sr. VP of Operations		Gutwald	David		1-631-881-2404	801304				dgutwald@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	04/12/2022	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Customer Service Operations Contact	National Director of Call Center Operations		Perez	Lizette	T	1-833-322-7526					ltperez@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	05/05/2022	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Government Relations Contact	VP, Government Affairs		Gormley	Carol		1-305-225-7266					cgormley@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee,	FL	32301	02/09/2021	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Hospice Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		1-786-679-6899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Medicare Compliance Officer	Chief Compliance Officer	Ms	Santamaria	Cary		1-786-759-4387					csantamaria@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	11/12/2021	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Part D Exceptions Contact	Director of Pharmacy Benefits		Prados	Yesenia						1-786-679-6899	yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active	1-855-344-0930				HMO - Health Maintenance Organization		C	Atlanta
H9986	Pharmacy Network Management Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		1-786-679-6899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Pharmacy Technical Help Desk Contact	Pharmacy Helpdesk		Helpdesk	Pharmacy						1-305-402-7827	cara.cox@cvshealth.com	2401 Cherahala Blvd.		Knoxville	TN	37932	05/16/2022	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active	1-866-693-4620				HMO - Health Maintenance Organization		C	Atlanta
H9986	Plan to Plan Reconciliation Contact	AVP & Controller		Rankin	Krystal		1-646-775-0693					KRankin@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/09/2021	2023	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9998	Automated TrOOP Balance Transfer Contact	Director of Data Management		Shell	Brian	C	1-806-767-1726				1-806-791-0578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	Best Available Evidence Contact	Director of Data Management		Shell	Brian	C	1-806-767-1726				1-806-791-0578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	Chief Financial Officer	CFO	MR.	CANNADAY	JASON		1-806-767-1650				1-806-766-0250	jcannaday@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	06/02/2016	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	CMS Casework Communication Contact	Silver Star Program Director	MRS.	Harwood	Joanne		1-806-773-7857				1-806-791-0578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	Coordination of Benefits Contact	Director of Data Management	Mr	Shell	Brian		1-806-767-1726				1-806-791-0578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	Customer Service Operations Contact	Silver Star Program Director	MRS.	Harwood	Joanne		1-806-773-7857				1-806-791-0578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	Government Relations Contact	CEO	MRS	Lawson	Beth		1-806-767-1648					blawson@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	09/29/2017	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	Medicare Compliance Officer	Part D Compliance Officer	MS.	HARRIS	KAREN		1-806-740-1407				1-806-766-0250	Kharris@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	08/28/2020	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	Part D Exceptions Contact	CFO	MR.	CANNADAY	JASON						1-806-766-0250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active	1-806-767-1650				PACE - Nat		C	Denver
H9998	Pharmacy Network Management Contact	Silver Star Program Director	MRS.	Harwood	Joanne		1-806-773-7857				1-806-791-0578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
H9998	Pharmacy Technical Help Desk Contact	Silver Star Program Director	MRS.	Harwood	Joanne						1-806-791-0578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active	1-806-773-7857				PACE - Nat		C	Denver
H9998	Plan to Plan Reconciliation Contact	Director of Data Management	MR	SHELL	BRIAN		1-806-767-1726				1-806-791-0578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2023	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	Denver
R0110	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R0110	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R0110	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0759	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/16/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Regional PPO		C	San Francisco
R0759	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0759	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Regional PPO		C	San Francisco
R0759	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R0865	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R0865	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0865	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R0865	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R0923	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0923	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R0923	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R1390	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1390	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R1390	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R1532	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R1532	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R2604	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-261-6024					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/22/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/16/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Regional PPO		C	San Francisco
R2604	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R2604	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Regional PPO		C	San Francisco
R2604	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Chief Financial Officer		Mr.	Hansen	Paul	D	1-952-979-6312					paul_d_hansen@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/08/2022	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Customer Service Operations Contact			Cantu	Nancy		1-952-931-5315					nancy.cantu@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Regional PPO		C	San Francisco
R3175	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3175	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Regional PPO		C	San Francisco
R3175	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3332	Automated TrOOP Balance Transfer Contact	Manager, PBM operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/27/2020	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Best Available Evidence Contact	Sr. Director EMB		Chick	Benjamin		1-904-905-1711					benjamin.chick@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	07/16/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Chief Financial Officer	SVP and CFO	Mr.	Justice	Thurman		1-904-905-5085					Thurman.Justice@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 8th Floor	Jacksonville	FL	32246	08/21/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	CMS Casework Communication Contact	Sr Manager Business Support		Stewart	Delores		1-904-905-0558					Delores.Stewart@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	07/17/2020	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Coordination of Benefits Contact	Manager PBM Operations		Hanson	Michelle		1-612-777-6755				1-312-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	02/16/2021	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Customer Service Operations Contact	Sr Director Member Contact		Gamble	LaTonya		1-904-905-2057					latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Government Relations Contact	Sr Director Govt Programs & Products Compliance		Simpson	Hillary		1-904-445-8502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	12/29/2021	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Hospice Contact	Pharmacist- Govt Pharmacy Prg		Adams	Tangela		1-904-905-0002					tangela.adams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 5th Floor	Jacksonville	FL	32246	01/22/2018	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Medicare Compliance Officer	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		1-904-445-8502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Part D Exceptions Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	1-800-477-3736	56307			Regional PPO		C	Atlanta
R3332	Pharmacy Network Management Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		1-904-905-6307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3332	Pharmacy Technical Help Desk Contact	Director, Member Services		Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	07/19/2021	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	1-888-877-6420				Regional PPO		C	Atlanta
R3332	Plan to Plan Reconciliation Contact	Accounting Specialist		Williams	Lynn		1-904-905-4568					lynn.williams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Regional CCP	Florida Blue	Regional PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					Regional PPO		C	Atlanta
R3392	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R3392	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3392	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R3392	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3444	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	03/30/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Regional PPO		C	San Francisco
R3444	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3444	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Regional PPO		C	San Francisco
R3444	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R3887	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R3887	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R3887	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R3887	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	05/28/2021	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	05/28/2021	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	05/20/2021	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	06/17/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	07/01/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	07/01/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/28/2021	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	515 West Market Street500 West Main Street		Louisville	KY	40202	12/28/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	05/28/2021	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	301 N. Hurstbourne Parkway		Louisville	KY	40222	05/28/2021	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R4182	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	07/01/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	10/30/2019	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R4182	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	05/28/2021	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4487	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				Regional PPO		C	Chicago
R4487	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4487	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				Regional PPO		C	Chicago
R4487	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R4845	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R4845	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4845	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R4845	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5329	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/10/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Regional PPO		C	San Francisco
R5329	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5329	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Regional PPO		C	San Francisco
R5329	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/10/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Regional PPO		C	San Francisco
R5342	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5342	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Regional PPO		C	San Francisco
R5342	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R5361	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R5361	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R5361	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R5495	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5495	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R5495	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R5826	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R5826	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5941	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				Regional PPO		C	Chicago
R5941	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R5941	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				Regional PPO		C	Chicago
R5941	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active					Regional PPO		C	Chicago
R6694	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		1-800-238-6279				1-888-665-6296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14088	Lexington	KY	40512-4088	06/12/2018	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	08/02/2019	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		1-214-552-8104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Customer Service Operations Contact	Sr. Director, Service Operations		Ellison	Christine		1-412-432-6289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	07/15/2020	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/24/2022	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/24/2022	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/24/2022	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active	1-602-618-3945				Regional PPO		C	Philadelphia
R6694	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6694	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active	1-800-238-6279				Regional PPO		C	Philadelphia
R6694	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/24/2022	2023	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Philadelphia
R6801	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/10/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Regional PPO		C	San Francisco
R6801	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R6801	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Regional PPO		C	San Francisco
R6801	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7220	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R7220	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R7220	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-502-580-9138				Regional PPO		C	Kansas City
R7315	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7315	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	1-800-865-8715				Regional PPO		C	Kansas City
R7315	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7444	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/10/2018	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Regional PPO		C	San Francisco
R7444	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
R7444	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Regional PPO		C	San Francisco
R7444	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	San Francisco
S0156	Automated TrOOP Balance Transfer Contact	Sr. Project Manager		Rush	Jamie		1-314-354-1103					ESITroopTransfer@express-scripts.com	One Express Way		St.Louis	MO	63121	04/27/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Best Available Evidence Contact	Manager, Enrollment and Billing		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road Suite 200		Glen Allen	VA	23060	04/27/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Chief Financial Officer	SVP, Controller	Mr.	Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	01/24/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	CMS Casework Communication Contact	Compliance Consultant		White	Jasmin		1-248-665-4235					JWhite4@bcbsm.com	1000 Town Center		Southfield	MI	48075	01/24/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Coordination of Benefits Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	04/27/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Customer Service Operations Contact	Director, Workforce Management, Analytics, & Supp		Weber	Julie		1-313-225-0555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	01/24/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Government Relations Contact	Manager, Performance and Oversight		Martell	Stacey		1-313-806-5905					smartell@bcbsm.com	1000 Town Center		Southfield	MI	48075	01/24/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Hospice Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		1-954-498-5880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/23/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	04/27/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-614-336-3326				Medicare Prescription Drug Plan		5	Chicago
S0156	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St.Louis	MO	63121	04/27/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0156	Pharmacy Technical Help Desk Contact	Director of Operations, Contact Center		Liu	Ian							iliu@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	04/27/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Chicago
S0156	Plan to Plan Reconciliation Contact	SVP, Controller		Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	01/24/2022	2023	NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY	PDP	NextBlue of North Dakota	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0586	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					wcolin@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Best Available Evidence Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		1-585-885-2361				1-585-327-2227	RMoxley@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	08/23/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Chief Financial Officer	Chief Financial Officer	Ms.	Austen	Karla		1-518-388-2357					kausten@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/26/2014	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	CMS Casework Communication Contact	Leader, Medicare Appeals		Allen	Amy		1-585-258-8096				1-585-327-5724	aallen@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	09/07/2021	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Coordination of Benefits Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					wcolin@mvphealthcare.com	220 Alexander St.		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Customer Service Operations Contact	Sr. Leader, Customer Care & Support Services		Greenberg	Melissa		1-518-991-3731					mgreenberg@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Government Relations Contact	Medicare Compliance Officer		Borges	Linda		1-518-991-3803				1-518-836-3202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Hospice Contact	Director, Pharmacy Management		Colin	Wendy		1-585-885-2435					WColin@mvphealthcare.com	220 Alexander St		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Borges	Linda		1-518-991-3803				1-518-836-3202	MCO@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Part D Exceptions Contact	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	220 Alexander St.		Rochester	NY	14607	11/08/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active	1-585-885-2435				Medicare Prescription Drug Plan		5	New York
S0586	Pharmacy Network Management Contact	Director Network Operations		Smith	Shawn		1-480-391-4844					shawn.smith@cvshealth.com	9501 E. Shea Blvd. MC 080		Scottsdale	AZ	85260	02/27/2019	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0586	Pharmacy Technical Help Desk Contact	Director, Client Operations		Leeper	Shonda							Shonda.Leeper@CVSHealth.com	445 Great Circle Rd		Nashville	TN	37228	12/03/2021	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active	1-866-693-4620				Medicare Prescription Drug Plan		5	New York
S0586	Plan to Plan Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		1-914-429-8496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2023	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	New York
S0655	Automated TrOOP Balance Transfer Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Best Available Evidence Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Chief Financial Officer	SVP Chief Financial Officer	Mr.	Kurpad	Umesh		1-781-612-1000	84968				umesh.kurpad@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	CMS Casework Communication Contact	Director, Appeals & Grievances	Ms.	Evans	Kathleen		1-617-972-9400	87204				kathleen.evans@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Coordination of Benefits Contact	Manager, Membership Accounting & Capitation	Ms.	Zakrzewski	Elaine		1-781-612-1000	82780				Elaine.Zakrzewski@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Customer Service Operations Contact	Manager, Member Services	Ms.	Villatoro	Yesly		1-781-612-1000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Government Relations Contact	Chief Government Affairs Officer	Ms.	Lewis	Kristin		1-781-612-1000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	01/18/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Hospice Contact	Manager, Pharmacy Operations & Programs	Ms.	MacAuley	Jacqueline		1-781-612-1000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Taylor	James		1-312-203-6938					james.taylor@point32health.org	1 Wellness Way		Canton	MA	02021	12/28/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active	1-781-612-1000	82370			Medicare Prescription Drug Plan		5	Boston
S0655	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		1-303-989-5828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	12/09/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0655	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							Todd.Summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	12/08/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active	1-855-524-0380				Medicare Prescription Drug Plan		5	Boston
S0655	Plan to Plan Reconciliation Contact	Manager, Finance Operations	Ms.	Olson	Rachel		1-781-612-1000	84360				rachel.olson@point32health.org	1 Wellness Way		Canton	MA	02021	01/19/2022	2023	TUFTS INSURANCE COMPANY	PDP	Tufts Health Plan	Medicare Prescription Drug Plan		Point32Health, Inc.	398	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1030	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Coordinator		Stephens	Andrew		1-205-220-2593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/13/2022	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Best Available Evidence Contact	Sr. Business Analyst		Johnson	Geraldine		1-205-220-6077					gejohnson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/11/2021	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Chief Financial Officer	SVP & Chief Financial Officer	Mr.	Carden	Noel		1-205-220-7741					ncarden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2022	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	CMS Casework Communication Contact	Senior Compliance Analyst		Jones	Kimberly		1-205-220-7077					kwjones@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/30/2021	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Coordination of Benefits Contact	Manager Claims Processing		Davis	Lori		1-205-220-6265					Lori.Davis@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/11/2018	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Customer Service Operations Contact	Dept Manager Customer Service		Pearson	Latreta		1-205-220-2601					llpearson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/13/2021	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Government Relations Contact	Manager Product Management	Mrs	Kullman	Christy	M	1-205-220-5915					CKullman@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/07/2019	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Hospice Contact	Pharmacy Operations Coordinator		Stevens	Andrew		1-205-220-2593					WStevens@bcbsal.org	450 Riverchase Pkwy East		Hoover	AL	35244	04/17/2019	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Gregg	Roger		1-205-220-7480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2013	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Part D Exceptions Contact	Regulatory Director		Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Mendota Heights	MN	55120	04/08/2021	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active	1-800-693-6651				Medicare Prescription Drug Plan		5	Atlanta
S1030	Pharmacy Network Management Contact	Pharmacy Services Mgr		Matthews	Ginny		1-205-220-6558				1-205-403-4052	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1030	Pharmacy Technical Help Desk Contact	Pharmacy Services Mgr		Matthews	Ginny							Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active	1-877-878-8668				Medicare Prescription Drug Plan		5	Atlanta
S1030	Plan to Plan Reconciliation Contact	Sr Analyst-Cash Management		Buford	Julie		1-205-220-7316					julie.buford@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	12/08/2021	2023	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S1140	Automated TrOOP Balance Transfer Contact	Manager, Federal Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-3075	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Best Available Evidence Contact	Manager		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Chief Financial Officer	CFO Highmark Health Plan	Mr.	Veach	Daryl		1-412-544-7531					Daryl.Veach@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/14/2021	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	CMS Casework Communication Contact	Manager, Government Programs Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	1701 North Street		Endicott	NY	13760	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		1-412-544-4417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	06/03/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Customer Service Operations Contact	Manager, Member Customer Service		Sheridan	Rebecca	L	1-518-220-5661				1-518-423-2294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	03/07/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Government Relations Contact	SVP, Government Affiars	Mr.	Warfel	Michael	G	1-717-302-3979					michael.warfel@highmark.com	1800 Center St.		Camp Hill	PA	17011	03/18/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Hospice Contact	Intake Coordinator		Welker	Jessica		1-717-888-3043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	11/09/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		1-412-544-7031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian						1-716-887-8981	Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/30/2016	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	1-614-336-3326				Medicare Prescription Drug Plan		5	Philadelphia
S1140	Pharmacy Network Management Contact	Network Account Director, Retail Strategy&Contract		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/09/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1140	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	12/17/2021	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Philadelphia
S1140	Plan to Plan Reconciliation Contact	Manager, Federal Enrollment & Billing		Smith	Kimberly		1-607-766-3043				1-888-282-2583	kimberly.r.smith@highmark.com	PO Box 80	Attention: Christa Dipasquale	Buffalo	NY	14240-0080	05/05/2022	2023	Highmark Western and Northeastern New York Inc.	PDP	Highmark BCBS of WNY and Highmark BS of NENY	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S1822	Automated TrOOP Balance Transfer Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	1-952-883-6536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Best Available Evidence Contact	Manager Membership Accounting		Marty	Amanda	E	1-952-967-7685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	55440-1309	11/05/2021	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Chief Financial Officer	EVP & Chief Financial Officer	Ms.	Cermak	Penny	D	1-952-883-7918					penny.d.cermak@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	55440-1309	09/13/2022	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	CMS Casework Communication Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	1-952-967-7679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	55440-9463	12/02/2022	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Coordination of Benefits Contact	Manager, Claims Production		Prine	Chantelle	M	1-952-967-7335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	55440-1309	04/20/2022	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Customer Service Operations Contact	Director Member Services		Renneke	Alison		1-952-967-7668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	55440-9463	01/29/2020	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Government Relations Contact	VP Government Programs		Clelland	Jennifer	J	1-952-967-5119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	55440-1309	08/30/2021	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Hospice Contact	Pharmacy Compliance Specialist		Riggs	Ben	H	1-952-851-8421					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	55440-1309	12/03/2021	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Medicare Compliance Officer	VP Internal Audit Comp Officer	Mr.	Bunde	Steven	D	1-952-883-6541				1-952-883-5522	steven.d.bunde@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	12/03/2021	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Exceptions Contact	Supervisor, Clinical Review		Whelan	Hillary	A					1-888-883-5434	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active	1-800-492-7259				Medicare Prescription Drug Plan		5	Chicago
S1822	Pharmacy Network Management Contact	Director Pharmacy Sales & Product Support		Friday	Ken	R	1-952-967-5826				1-952-967-6667	kenneth.r.friday@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	11/23/2020	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Pharmacy Technical Help Desk Contact	Manager Health Plan Pharmacy Customer Service		Whelan	Hillary	A					1-888-883-5434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	55440-1309	12/19/2022	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active	1-800-492-7259				Medicare Prescription Drug Plan		5	Chicago
S1822	Plan to Plan Reconciliation Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	1-952-883-6584				1-952-883-6500	kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	55440-1309	05/09/2013	2023	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2465	Automated TrOOP Balance Transfer Contact	Director of Pharmacy Ops & Compliance		May	Crystal		1-804-687-8378				1-757-692-5575	RxBenefits@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Best Available Evidence Contact	Director Enrollment & Disenrollment		Brown	Sheila		1-757-252-8015				1-757-692-5575	sxbrown29@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Chief Financial Officer	Director Medicare Finance	Ms.	Eagleson	Leigh		1-443-851-6654				1-757-552-7396	laeagles@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	CMS Casework Communication Contact	Manager Regulatory Compliance		Monroe	Latasha		1-804-721-7037					lajones4@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Coordination of Benefits Contact	Direct Ops Support		Driskill	Kenneth		1-804-819-5151				1-757-687-6231	kwdriski@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Customer Service Operations Contact	Director, Customer Services		Brogan	Kim		1-757-434-9999				1-757-552-7116	krbrogan@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Government Relations Contact	Director Government Programs - Medicare		Hoffman	Daniel		1-757-983-2540				1-757-552-7396	dehoffma@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Hospice Contact	Manager Pharmacy Benefits	Ms.	Strickland	Brandi		1-757-252-8193					RxBenefits@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Green	Janet		1-813-368-2227					JLGREE13@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Part D Exceptions Contact	Clinical Pharmacist Medicare		Snow	Michael						1-757-962-5575	mzsnow@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active	1-757-552-8954				Medicare Prescription Drug Plan		5	Philadelphia
S2465	Pharmacy Network Management Contact	VP, Pharmacy		Daw	Jessica		1-757-252-8181				1-757-962-5575	jrdaw@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	02/11/2020	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2465	Pharmacy Technical Help Desk Contact	Mgr Pharmacy Help Desk		Summers	Todd							todd.summers@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	11/12/2021	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active	1-866-603-7514				Medicare Prescription Drug Plan		5	Philadelphia
S2465	Plan to Plan Reconciliation Contact	Accounting Manager		Duncan	April		1-757-252-8055				1-757-252-8030	acmorgan@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	02/11/2020	2023	OPTIMA HEALTH PLAN	PDP	Optima Medicare	Medicare Prescription Drug Plan		Sentara Health Care (SHC)	345	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S2468	Automated TrOOP Balance Transfer Contact	Senior Manager, Medicare Operations		Halley	Derek		1-818-228-6374					Derek.Halley@blueshieldca.com	6300 Canoga Ave,		Woodland Hills	CA	91367	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Best Available Evidence Contact	Manager, Medicare Operations		Loreto	Alfonso		1-818-228-7005					Alfonso.Loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Chief Financial Officer	Senior Director, Medicare Finance	Mr.	Ballou	Taylor		1-818-228-6697					Taylor.Ballou@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		1-818-228-2651					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Coordination of Benefits Contact	Manager, Medicare Operations		Loreto	Alfonso		1-818-228-7005					alfonso.loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	11/02/2017	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Customer Service Operations Contact	Operations Specialist, Consultant		Lopez	Cynthia		1-818-228-6251					Cynthia.Lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Government Relations Contact	Senior Manager, Medicare Compliance		Mata	Marcos		1-818-228-6048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Hospice Contact	Senior Program Manager		Fields	Torrie		1-415-229-5839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	02/02/2018	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		1-818-228-7028					Richard.Robinson@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Part D Exceptions Contact	Director, Pharmacy Prior Authorization		March	Nancee							nancee.march@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	1-800-776-4466				Medicare Prescription Drug Plan		5	San Francisco
S2468	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		1-510-607-2901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2468	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	1-888-970-0933				Medicare Prescription Drug Plan		5	San Francisco
S2468	Plan to Plan Reconciliation Contact	Financial Analyst Consultant		Dahl	Chris		1-818-228-2575					BSCP2PRecon@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2023	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S2668	Automated TrOOP Balance Transfer Contact	General Counsel	Mr.	Brown	Ryan	D	1-931-560-0041	2449				rbrown@fbhealthplans.com	P.O. Box 313		Columbia	TN	38402	02/15/2016	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Best Available Evidence Contact	General Counsel	Mr.	Brown	Ryan	D	1-931-560-0041	2449				rbrown@fbhealthplans.com	P.O. Box 313		Columbia	TN	38402	02/15/2016	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Chief Financial Officer	Chief Financial Officer	Mrs.	Adams	Renee		1-931-560-0041	3108				radams@fbhealthplans.com	P.O. Box 313		Columbia	TN	38402	04/26/2017	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	CMS Casework Communication Contact	Compliance Officer	Mr.	Beard	Jason	C	1-931-560-0041	3125				jbeard@fbhealthplans.com	P.O. Box 313		Columbia	TN	38402	08/13/2019	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Coordination of Benefits Contact	Manager, Business Process	Mr.	Diaz	Mario		1-949-475-3517					mario.diaz@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	06/01/2020	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Customer Service Operations Contact	Service Account Manager	Ms.	Banks	Tracy		1-520-918-9825					tracy.banks@optum.com	PO Box 9472		Minneapolis	MN	55440	06/01/2020	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Government Relations Contact	General Counsel	Mr.	Brown	Ryan	D	1-931-560-0041	2449				rbrown@fbhealthplans.com	P.O. Box 313		Columbia	TN	38402	02/15/2016	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Hospice Contact	Pharmacist		Marks	Iny		1-412-218-9916					iny.marks@optum.com	PO Box 9472		Minneapolis	MN	55440	06/01/2020	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Medicare Compliance Officer	Compliance Officer	Mr.	Tutaj	Thomas		1-931-560-0041	6461				ttutaj@fbhp.com	P.O. Box 313		Columbia	TN	38402	05/04/2022	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Part D Exceptions Contact	Manager, Prior Authorization		Mourad	Hala							Hala.Mourad@optum.com	2441 Warrenville Rd	Suite 400	Lisle	IL	60532	06/29/2018	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active	1-630-328-5837				Medicare Prescription Drug Plan		5	Atlanta
S2668	Pharmacy Network Management Contact			Pham	Katie		1-817-846-8722					Katie.Pham@optum.com	2290 Prairie Wind Path, Lewisville, TX 75056		Lewisville	TX	75056	06/03/2020	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2668	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Summers	Todd							Todd.Summers@optum.com	755 Research Parkway	Suite 300	Oklahoma City	OK	73104	05/15/2019	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active	1-866-643-6924				Medicare Prescription Drug Plan		5	Atlanta
S2668	Plan to Plan Reconciliation Contact	General Counsel	Mr.	Brown	Ryan	D	1-931-560-0041	2449				rbrown@fbhealthplans.com	P.O. Box 313		Columbia	TN	38402	02/15/2016	2023	MEMBERS HEALTH INSURANCE COMPANY	PDP	Farm Bureau Health Plans	Medicare Prescription Drug Plan		Tennessee Rural Health Improvement Association	651	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S2874	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	1-502-580-9138				Medicare Prescription Drug Plan		5	Kansas City
S2874	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2874	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	1-800-865-8715				Medicare Prescription Drug Plan		5	Kansas City
S2874	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE OF PUERTO RICO, INC.	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S2893	Automated TrOOP Balance Transfer Contact	Manager Strategic Accounts		Pityou	Sean		1-602-245-8871					JEAccountManagement@CVSCaremark.com	9501 E. Shea BLVD		Scottsdale	AZ	85260	06/16/2022	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Best Available Evidence Contact	Manager		Mondhink	Tiffany		1-480-614-7228					Tiffany.Mondhink@CVSHealth.com	9501 E. Shea Blvd, MC125		Scottsdale	AZ	85260	11/14/2019	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Chief Financial Officer	Chief Financial Officer	Ms.	Santangelo	Andreana		1-617-246-3600					Andreana.Santangelo@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	02199-7611	12/19/2016	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	CMS Casework Communication Contact	Supervisor, Medicare Part D Operations		Rocco	Lori		1-480-392-7135					Lori.Rocco@CVSHealth.com	9501 E. Shea BLVD, MC146		Scottsdale	AZ	85260	12/16/2020	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Coordination of Benefits Contact	Manager, MED D Financial Reconciliation		Viana	Silvia		1-480-298-0166					Silvia.Viana@cvshealth.com	9501 E.Shea BLVD,	MC121	Scottsdale	AZ	85260	06/08/2020	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Customer Service Operations Contact	Lead Director, Client Operations		Dayoub	Joselyn		1-412-875-7137					dayoubj@cvshealth.com	315 Cloisterbane Drive		St. Johns	FL	32259	10/11/2022	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Government Relations Contact	Senior Director of Federal and National Affairs		Savage	Deirdre		1-617-246-3359					deirdre.savage@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	02199-7611	10/24/2019	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Hospice Contact	Manager Strategic Accounts		Pityou	Sean		1-602-245-8871					JEAccountManagement@CVSHealth.com	9501 E.Shea BLVD		Scottsdale	AZ	85260	06/16/2022	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Sullivan	Christina		1-781-603-8012					NEJECompliance@bcbsma.com	25 Technology Place	Mail stop 03/04	Hingham	MA	02043-4359	04/28/2022	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Part D Exceptions Contact	Manager RPh, Medicare Part D CD&A Client Support		Moran	Vickie							Vickie.Moran@CVSHealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/09/2021	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active	1-412-526-3320				Medicare Prescription Drug Plan		5	Boston
S2893	Pharmacy Network Management Contact	Director, Network Operations		Smith	Shawn		1-480-652-9980					Shawn.Smith@CVSHealth.com	9501 E. Shea BLVD		Scottsdale	AZ	85260	12/16/2020	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S2893	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							dayoubj@cvshealth.com	800 NW Chipman, Rd. Suite 5830		Lee''s Summit	MO	64086	10/11/2022	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active	1-866-693-4620				Medicare Prescription Drug Plan		5	Boston
S2893	Plan to Plan Reconciliation Contact	Sr. Consultant, Finance Med D		Palmer	Richard		1-480-402-1370					Richard.Palmer@CVSHealth.com	PO Box 842237		Dallas	TX	75284-2237	04/05/2021	2023	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S3147	Automated TrOOP Balance Transfer Contact	Supervisor Financial Analysis Consultant	Mr	Marshall	Gregory		1-480-684-5209					Gregory.Marshall@bannerhealth.com	2901 N. Central Ave Ste. 160		Phoenix	AZ	85012	12/27/2021	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Best Available Evidence Contact	Medicare Enrollment Sr. Mgr.	Mrs	Paredes	Nadya		1-520-874-5964				1-520-874-7083	Nadya.Paredes@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	02/14/2021	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Chief Financial Officer	Chief Financial Officer	Mr.	Aubrey	Rob		1-832-540-2074					Rob.Aubrey@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	03/07/2022	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	CMS Casework Communication Contact	Director, Grievance and Appeals	Mr	Maccioli	James		1-520-874-3247				1-520-874-7083	James.Maccioli2@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	12/20/2021	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Coordination of Benefits Contact	Director Reimbursement Services		Groves	Lori		1-602-469-2249					Lori.Groves@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/30/2021	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Customer Service Operations Contact	Customer Care Director	Mrs	Carrillo	Veronica		1-520-874-5349				1-520-874-7083	Veronica.Carrillo@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	02/14/2021	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Government Relations Contact	Government Programs Sr. Director	Mr.	Thomsen	Ryan		1-520-780-8310					ryan.thomsen@bannerhealth.com	2701 E. Elvira Rd		Tucson	AZ	85756	04/19/2022	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Hospice Contact	Pharmacy Director	Mr	Pokorney	Tim		1-602-747-2101					Timothy.Pokorney@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	09/27/2021	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Medicare Compliance Officer	Compliance Senior Director	Ms	Corlette	Kristina		1-602-747-2431					BMAComplianceOfficer@BannerHealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/05/2022	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Part D Exceptions Contact	Express Scripts Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	Express Scripts	5151 Blazer Pkwy	Dublin	OH	43017	12/21/2021	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active	1-800-344-3405	733326			Medicare Prescription Drug Plan		5	San Francisco
S3147	Pharmacy Network Management Contact	Express Scripts Network Accountant Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	12/21/2021	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3147	Pharmacy Technical Help Desk Contact	Express Scripts (Director, Customer Services)		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	Express Scripts	13051 N Telecom PKWY STE 150	Temple Terrace	FL	33637	12/16/2022	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active	1-866-662-0295				Medicare Prescription Drug Plan		5	San Francisco
S3147	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Aubrey	Rob		1-832-540-2074					Rob.Aubrey@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	03/07/2022	2023	BANNER HEALTH INSURANCE GROUP	PDP	Banner Medicare Rx	Medicare Prescription Drug Plan		Banner Health	389	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager	Mr.	Zlotkus	Steve		1-858-790-6250					PartDCAT@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	05/15/2018	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Best Available Evidence Contact	Program Associate	Ms.	Mays	Dara		1-858-790-5710					dara.mays@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2022	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Chief Financial Officer	President, MG Insurance Company	Mr.	Barr	Damien		1-858-790-6330					damien.barr@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/25/2020	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	CMS Casework Communication Contact	Director, PDP Operations	Ms.	Bossert	Michele		1-858-790-6323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Coordination of Benefits Contact	Program Associate	Ms.	Mays	Dara		1-858-790-5710					dara.mays@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2022	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Customer Service Operations Contact	Director, PDP Operations	Ms.	Bossert	Michele		1-858-790-6323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Government Relations Contact	Compliance Officer	Mr.	Evans	Niejadd		1-858-790-6294					niejadd.evans@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/16/2018	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Hospice Contact	Program Associate	Ms.	Mays	Dara		1-858-790-5710					dara.mays@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2022	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Medicare Compliance Officer	Compliance Officer	Mr.	Evans	Niejadd		1-858-790-6294					niejadd.evans@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/16/2018	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Part D Exceptions Contact	Compliance Officer	Mr.	Evans	Niejadd							niejadd.evans@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/16/2018	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active	1-858-790-6294				Medicare Prescription Drug Plan		5	San Francisco
S3285	Pharmacy Network Management Contact		Ms.	Robertson	Jeanine		1-858-790-6108					Jeanine.Robertson@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	04/16/2019	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3285	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/18/2018	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active	1-844-826-3451				Medicare Prescription Drug Plan		5	San Francisco
S3285	Plan to Plan Reconciliation Contact	Financial Data Recon Analyst	Mr.	Hallman	Blake		1-858-790-7493					blake.hallman@medimpact.com	PO Box 78606		Milwaukee	WI	53278-8606	07/11/2019	2023	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3375	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				Medicare Prescription Drug Plan		5	Chicago
S3375	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3375	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				Medicare Prescription Drug Plan		5	Chicago
S3375	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	EMPIRE HEALTHCHOICE ASSURANCE, INC.	PDP	BlueCross BlueShield: Empire, Excellus, WNY & NENY	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3389	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		1-412-454-5539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		1-412-454-5559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	07/18/2016	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	CMS Casework Communication Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		1-412-454-5250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		1-412-454-7664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		1-877-539-3080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		1-412-454-8589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		1-412-454-5247				1-412-454-2110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	08/29/2012	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active	1-800-396-4139				Medicare Prescription Drug Plan		5	Philadelphia
S3389	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	10/31/2016	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3389	Pharmacy Technical Help Desk Contact	DIrector, Customer Service		Warren	Mark							MWarren@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	07/29/2021	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Philadelphia
S3389	Plan to Plan Reconciliation Contact	Business Analyst		Michalski	Jeff		1-412-454-5715				1-412-454-2110	medicarereporting@upmc.edu	c/o UPMC Health Plan Attn: Jeff Michalski P2P	US Steel Tower, 600 Grant Street, 9th Floor	Pittsburgh	PA	15219	06/22/2020	2023	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S3521	Automated TrOOP Balance Transfer Contact	Medicare Product Operations Specialist		Laird	Jennifer		1-585-339-7717					Jennifer.Laird@excellus.com	165 Court Street		Rochester	NY	14647	04/28/2014	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Best Available Evidence Contact	Supervisor Medicare Operations		Piershalski	Dana		1-716-857-4435				1-716-857-6160	medicare.reconciliation.unit@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Chief Financial Officer	Executive Vice President & Chief Financial Officer	Mr.	Gorecki	Christophe	M	1-480-993-5254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	CMS Casework Communication Contact	Medicare Compliance Program Administrator		Gomez	Rafael		1-716-857-6226					Rafael.Gomez@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Coordination of Benefits Contact	Supervisor, Other Party Liability		May	Mary		1-315-792-8873					Mary.May@excellus.com	12 Rhoads Dr.		Utica	NY	13502	04/15/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Customer Service Operations Contact	Vice President, Customer Care		Levi	Alexander		1-585-399-6683					Alexander.Levi@excellus.com	300 Main St.		East Rochester	NY	14445	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Government Relations Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		1-585-339-7745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Hospice Contact	Manager, Pharmacy Utilization Management		Khan	Joe		1-716-843-7881					Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	09/29/2020	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dibble	Laura		1-585-339-7745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Part D Exceptions Contact	Manager, Pharmacy Utiization Management		Khan	Joe							Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	09/29/2020	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active	1-716-843-7881				Medicare Prescription Drug Plan		5	New York
S3521	Pharmacy Network Management Contact	Pharmacy Operations Support		Brown	Burt		1-585-327-7530				1-585-339-6640	Burt.Brown@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3521	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkway	Ste 150	Temple Terrace	FL	33637	12/28/2021	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	New York
S3521	Plan to Plan Reconciliation Contact	Manager, Finance Operations		Simmons	Jennifer		1-585-231-6874					Jennifer.Simmons@excellus.com	165 Court Street		Rochester	NY	14647	12/08/2022	2023	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	New York
S3875	Automated TrOOP Balance Transfer Contact	Senior Manager Claims Operations		Arinsberg	Valerie		1-855-586-2573				1-888-656-8099	SLCPDP@magellanhealth.com	4801 East Washington Street Suite 100		Phoenix	AZ	85034	09/29/2020	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Best Available Evidence Contact	Director Enrollment and Correspondence	Mr.	Valdivia	Luguer		1-855-586-2573				1-888-656-8099	SLCEnrollment@magellanhealth.com	4801 East Washington Street Suite 100		Phoenix	AZ	85034	09/29/2020	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Chief Financial Officer	Chief Financial Officer	Ms	Tveit	Kristen		1-407-967-4642				1-888-656-8099	KETveit@magellanhealth.com	4801 East Washington Street Suite 100		Phoenix	AZ	85034	05/26/2021	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	CMS Casework Communication Contact	Compliance Officer		Lang	Larissa		1-401-239-8035					llang@magellanhealth.com	4801 East Washington Street  Suite 100		Phoenix	AZ	85034	09/21/2022	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Coordination of Benefits Contact	Senior Manager, Enrollment and Communications	Mr	Valdivia	Luguer		1-801-503-0117				1-888-656-8099	SLCPDP@magellanhealth.com	4801 East Washington Street	Suite 100	Phoenix	AZ	85034	05/28/2021	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Customer Service Operations Contact	Manager, Clinical Pharmacy Operations		DiBiase	Joseph		1-401-344-1059				1-888-656-8099	SLCPDP@magellanhealth.com	4801 East Washington Street	Suite 100	Phoenix	AZ	85034	05/26/2021	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Government Relations Contact	Compliance Officer		Lang	Larissa		1-401-239-8035					llang@magellanhealth.com	4801 East Washington Street	Suite 100	Phoenix	AZ	85034	09/21/2022	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Hospice Contact		Ms.	Ibenskis	Sara	N	1-801-503-0117				1-888-656-8099	SLCPDP@magellanhealth.com	4801 East Washington Street	Suite 100	Phoenix	AZ	85034	05/26/2021	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Medicare Compliance Officer	Compliance Officer	Ms.	Lang	Larissa		1-401-239-8035				1-888-656-8099	llang@magellanhealth.com	4801 East Washington Street	Suite 100	Phoenix	AZ	85034	09/21/2022	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Exceptions Contact	Manager Clinical Pharmacy Operations		DiBiase	Joseph						1-888-656-8099	SLCPDP@magellanhealth.com	4801 East Washington Street	Suite 100	Phoenix	AZ	85034	05/26/2021	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	1-401-344-1059				Medicare Prescription Drug Plan		5	Dallas
S3875	Pharmacy Network Management Contact			Gimm	Joy		1-602-615-3241					JGimm@magellanhealth.com	15950 North 76th Street Suite 200		Scottsdale	AZ	85260	01/08/2020	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Pharmacy Technical Help Desk Contact			DiBiase	Joseph								4801 East Washington Street	Suite 100	Phoenix	AZ	85034	05/26/2021	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	1-804-548-0494				Medicare Prescription Drug Plan		5	Dallas
S3875	Plan to Plan Reconciliation Contact	Manager Finance Med D		Nataliya	Tressler		1-480-624-9383					ntressler@magellanhealth.com	PO Box 785341		Philadelphia	PA	19178	08/25/2020	2023	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3994	Automated TrOOP Balance Transfer Contact	Senior Business Analyst		Kalino	Karen		1-808-948-6262				1-808-948-6585	karen_apiki_kalino@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	11/27/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Best Available Evidence Contact	Manager, Membership Services		Makio	Lani		1-808-948-6215				1-808-948-6285	lani_makio@hmsa.com	P.O. Box 860	7 - MS	Honolulu	HI	96808	12/04/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Chief Financial Officer	EVP, Chief Financial Officer	Ms.	Marting	Gina		1-808-948-5696				1-808-948-5999	gina_marting@hmsa.com	P.O. Box 860	11 - EXEC	Honolulu	HI	96808-0860	12/23/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	CMS Casework Communication Contact	Medicare Grievance & Appeal Coordinator		Hartenstein	Renee		1-808-948-5347				1-808-952-7546	Renee_Hartenstein@hmsa.com	P.O. Box 860	KB-MAA	Honolulu	HI	96808	12/29/2021	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Coordination of Benefits Contact	Sr Mgr, Internal Operations		Shimamura	Ross		1-808-948-6294					ross_shimamura@hmsa.com	P.O. Box 860	7-CA	Honolulu	HI	96808	10/27/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Customer Service Operations Contact	Manager, Customer Relations Operations		Unger	Kevin		1-808-948-6186				1-808-948-5567	Customer-service@hmsa.com	P.O. Box 860	7 CR	Honolulu	HI	96808	10/27/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Government Relations Contact	SVP, Government		Diesman	Jennifer		1-808-561-6397				1-808-948-6860	jennifer_diesman@hmsa.com	P.O. Box 860	11 EXEC	Honolulu	HI	96808	10/27/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Hospice Contact	Business Analyst - Medicare Part D		Pagura	Herch		1-808-948-6559				1-808-948-5611	herch_pagura@hmsa.com	PO Box 860	PM - Administration	Honolulu	HI	96808	11/03/2021	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Rivad	Maila		1-808-948-5767				1-808-948-6585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	01/23/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Part D Exceptions Contact	Manager, Clinical Pharmacy		Kuniyoshi	Derek						1-808-948-8298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	12/04/2020	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active	1-800-462-2085				Medicare Prescription Drug Plan		5	San Francisco
S3994	Pharmacy Network Management Contact	Director		Smith	Shawn		1-480-391-4844					shawn.smith@cvshealth.com	9501 E. Shea Blvd., MC080	CVS Caremark	Scottsdale	AZ	85260	12/20/2019	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S3994	Pharmacy Technical Help Desk Contact	Lead Director, Client Operations Customer Care		Neiman	Beth							Beth.Neiman@CVSHealth.com	100 Mall Blvd	CVS Specialty	Monroeville	PA	15146	11/07/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active	1-866-693-4620				Medicare Prescription Drug Plan		5	San Francisco
S3994	Plan to Plan Reconciliation Contact	Director, Government Accounting and Reporting		Nakashima	Marla		1-808-948-6020				1-808-948-5063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2023	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S4219	Automated TrOOP Balance Transfer Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Best Available Evidence Contact	Medicare Enrollment Manager		Kirby	Rae		1-217-902-9108					rae.kirby@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Chief Financial Officer	Chief Financial Officer	Mr.	Bradford	Jerry		1-217-902-9002				1-217-902-9740	Jerry.Bradford@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	10/18/2021	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	CMS Casework Communication Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Coordination of Benefits Contact	Director of Claims & Recovery		Parker	Lisa		1-217-902-8353				1-217-902-9786	lisa.parker@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Customer Service Operations Contact	Director of Customer Solutions		Marquardt	Jennifer		1-217-902-9229				1-217-902-9705	Jennifer.Marquardt@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	05/30/2018	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Government Relations Contact	CEO		Madigan	Sinead		1-217-902-8301				1-217-902-9740	sinead.madigan@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Hospice Contact	Director of Pharmacy		Buhr	Aimee		1-217-902-9366					Aimee.Buhr@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Wilson	Hollie		1-217-902-8224				1-217-902-9794	Hollie.Wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/02/2019	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Part D Exceptions Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active	1-217-902-8224				Medicare Prescription Drug Plan		5	Chicago
S4219	Pharmacy Network Management Contact	VP, Chief Compliance Officer		Wilson	Hollie		1-217-902-8224				1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4219	Pharmacy Technical Help Desk Contact	VP, Chief Compliance Officer		Wilson	Hollie						1-217-902-9794	hollie.wilson@healthalliance.org	3310 Fields South Drive		Champaign	IL	61822	08/22/2022	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active	1-844-265-1876				Medicare Prescription Drug Plan		5	Chicago
S4219	Plan to Plan Reconciliation Contact			Tizora	Elizabeth		1-217-902-9469					elizabeth.tizora@healthalliance.org	3310 Fields South Dr		Champaign	IL	61822	03/14/2019	2023	HEALTH ALLIANCE MEDICAL PLANS	PDP	Health Alliance Medicare Prescription Plan	Medicare Prescription Drug Plan		The Carle Foundation	583	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S4501	Automated TrOOP Balance Transfer Contact	Directory-Pharmacy Services and Operations		Malcolm	Jillian		1-716-635-3754					Jillian.Malcolm@Independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Best Available Evidence Contact	Manager - Enrollment Operations		Sell	Melanie		1-716-250-7321				1-716-250-7162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Chief Financial Officer	Executive Vice President - Chief Financial Officer	Mr.	Dunlop	James		1-716-631-3001					James.Dunlop@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/06/2021	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	CMS Casework Communication Contact	Manager Enrollment Operations		Sell	Melanie		1-716-250-7321				1-716-250-7162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Coordination of Benefits Contact	Manager - Corporate Recoveries		Abou-Said	Kelly		1-716-635-3758					Kelly.Abou-Said@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/07/2022	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Customer Service Operations Contact	Manager - Provider & Member Services		Bogacz	Lindsay		1-716-635-3973					Lindsay.Bogacz@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/08/2020	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Government Relations Contact	SVP Government Programs		Tracy	Robert		1-716-635-4904					Robert.Tracy@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Hospice Contact	Director-Pharmacy Services and Operations		Malcolm	Jillian		1-716-635-3754					Jillian.Malcolm@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Britton	Nicole		1-716-635-4874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/20/2018	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Part D Exceptions Contact	VP- Pharmacy Services		Burruano	Martin						1-716-631-0149	Martin.Burruano@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active	1-800-247-1466	5311			Medicare Prescription Drug Plan		5	New York
S4501	Pharmacy Network Management Contact	VP Pharmacy Services		Burruano	Martin		1-716-225-7559				1-716-631-9636	Martin.Burruano@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4501	Pharmacy Technical Help Desk Contact	Supervisor-Member Servicing		Bates	Taylor							Taylor.Bates@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/02/2022	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active	1-800-993-9898				Medicare Prescription Drug Plan		5	New York
S4501	Plan to Plan Reconciliation Contact	Pharmacy Systems Gov. Programs Manager		Miszuk	Jane		1-716-635-7857					Jane.Miszuk@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/11/2019	2023	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active					Medicare Prescription Drug Plan		5	New York
S4802	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		1-813-206-7131					.LISOVR@WELLCARE.COM	8735 Henderson Rd		Tampa	FL	33634	09/29/2022	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Chief Financial Officer	Vice President, Data Analytics & Reporting	Mr.	Xiong	Yan		1-813-206-5163					Yan.Xiong@CENTENE.COM	8715 Henderson Road		Tampa	FL	33634	10/19/2022	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	CMS Casework Communication Contact	Service Escalation Unit		Casework	CMS		1-866-675-8573					ctm_box@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	10/06/2022	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Coordination of Benefits Contact	Senior Director, Claims Operations		Everett	Thomas		1-813-495-8381					thomas.everett@wellcare.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Customer Service Operations Contact	Senior Director, Customer Service		Morrison	Matthew		1-813-206-3618					matthew.morrison@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/03/2021	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Government Relations Contact	Director, Health Policy	Ms.	Fairman	Brittney		1-202-253-7949					Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washington	DC	20036	09/29/2022	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		1-314-349-3212					jeffrey.borowiecki@envolvehealth.com	8735 Henderson Rd		Tampa	FL	33634	09/21/2022	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Medicare Compliance Officer	Vice President, Ethics & Compliance	Ms.	Gregory	Lori-Don		1-727-698-2780					LoriDon.M.Gregory@CENTENE.COM	7700 Forsyth Boulevard Clayton		Clayton	MO	63105	11/10/2022	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Part D Exceptions Contact	Sr. Director, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8735 Henderson Road		Tampa	FL	33634	02/03/2021	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	1-813-206-7152				Medicare Prescription Drug Plan		5	Dallas
S4802	Pharmacy Network Management Contact	Sr. Director, Pharmacy Program Management	Mr.	Swartz	Adam		1-813-206-3708					adam.swartz@wellcare.com	8735 Henderson Road		Tampa	FL	33634	03/09/2021	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4802	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers	Mr.	Bollent	Jason							Jason.Bollent@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/03/2021	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	1-855-538-0453				Medicare Prescription Drug Plan		5	Dallas
S4802	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		1-813-206-6231				1-813-283-3302	P2P-CASH@wellcare.com	8735 Henderson Road, Ren 1, 2nd Floor	Attn: P2P Department	Tampa	FL	33634	02/03/2021	2023	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5450	Automated TrOOP Balance Transfer Contact	Advisor Business CVS		Davis	Brittany		1-480-606-4613					FIRSupport@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/21/2021	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Best Available Evidence Contact	Manager MedAdv Member & Recon		Mills	Aaron		1-423-535-3848					Aaron_Mills@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/16/2015	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Chief Financial Officer	Interim CFO Security Care, Inc	Mr	Giblin	John		1-423-535-4884				1-423-535-6432	John_Giblin@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/01/2021	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	CMS Casework Communication Contact	Manager Operations		Flagg	Kendra		1-423-535-7524				1-423-535-5498	Kendra_Flagg@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/17/2019	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Coordination of Benefits Contact	Manager Revenue Reconciliation		Camp	Jan		1-423-535-3639					Jan_Camp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/11/2019	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Customer Service Operations Contact	Manager Operations		Walters	Karen		1-423-535-7696					Karen_Walters@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	07/15/2015	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Government Relations Contact	Medicare Compliance Officer	Ms.	Womble	Charriet		1-615-347-9580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Hospice Contact	Supervisor, Medicare Advantage Revenue Reconciliat		Cross	Jennifer	R	1-423-535-5969	5969			1-423-535-5498	Jennifer_Cross@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/07/2018	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Medicare Compliance Officer	Medicare Compliance Officer	Mrs	Womble	Charriet		1-615-347-9580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Part D Exceptions Contact	Manager Coverage Reviews 1		Moss	Portia							Portia_Moss@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/08/2019	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active	1-800-831-2583				Medicare Prescription Drug Plan		5	Atlanta
S5450	Pharmacy Network Management Contact	Advisor Network Products CVS		Lowe	David		1-480-744-9231				1-877-387-5800	David.Lowe2@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/20/2021	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5450	Pharmacy Technical Help Desk Contact	Vendor Management		Horton	Kasena							Kasena.Horton@CVSHealth.com	2401 Cherahala  Blvd		Knoxville	TN	37932	12/21/2021	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active	1-866-693-4620				Medicare Prescription Drug Plan		5	Atlanta
S5450	Plan to Plan Reconciliation Contact	Business Analyst Associate		Stinnett	James		1-423-535-1624					P2PAdministration_GM@bcbst.com	Attn: P2P Coordinator	1 Cameron Hill Circle Suite 0050	Chattanooga	TN	37402-0050	02/07/2018	2023	SECURITYCARE OF TENNESSEE, INC.	PDP	BlueScripts	Medicare Prescription Drug Plan		BlueCross BlueShield of Tennessee	34	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations		Hanson	Michelle		1-612-777-6706					eobp2p@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		1-919-765-2438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Chief Financial Officer	SVP, Chief Financial Officer and Treasurer	Mr.	Perry	Mitchell	W	1-919-765-3923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/21/2018	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	CMS Casework Communication Contact	Mgr, Op Qual & Compliance - Regulatory Complaints		Henderson	Nicole		1-919-765-1320					Caseworker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/26/2019	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Coordination of Benefits Contact	Team Leader, Claims		McGregory	Ann		1-336-201-4530					Ann.McGregory@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	5660 University Pkwy	Winston Salem	NC	27105	07/15/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		1-919-765-7057					Renita.Woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	07/18/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Government Relations Contact	Director, CMS Contract Administration		Washington-McNeill	Deborah		1-336-692-3556				1-336-659-2969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	5660 University Pkwy	Winston-Salem	NC	27105	06/15/2017	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Hospice Contact	Pharmacy Services Coordinator		Leggett	Ursula		1-919-765-4599					Ursula.Leggett@bcbsnc.com	PO Box 2291		Durham	NC	27702	02/01/2018	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Medicare Compliance Officer	VP,Comml & Medicare Compliance, Compliance Officer	Mrs.	Dreyer	Amber		1-984-960-3306					amber.dreyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	02/06/2020	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Exceptions Contact	Manager		Swanson	Ryan							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/30/2021	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active	1-888-296-9790				Medicare Prescription Drug Plan		5	Atlanta
S5540	Pharmacy Network Management Contact	AVP, Pharmacy Government Programs		Geter	Joseph		1-919-765-7733					joseph.geter@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/17/2022	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							MGarzarodriguez@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2021	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active	1-877-277-7893				Medicare Prescription Drug Plan		5	Atlanta
S5540	Plan to Plan Reconciliation Contact	Manager, Financial Accounting & Reporting		Hitchcock	Grace		1-919-765-7999					grace.hitchcock@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	PO Box 30060 Mailstop 700-1AP	Durham	NC	27702	12/29/2021	2023	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		Blue Cross and Blue Shield of North Carolina	265	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5552	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	1-502-580-9138				Medicare Prescription Drug Plan		5	Kansas City
S5552	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5552	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	1-800-865-8715				Medicare Prescription Drug Plan		5	Kansas City
S5552	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY OF NEW YORK	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5584	Automated TrOOP Balance Transfer Contact	Manager	Mr.	Nalamolu	Chandra		1-248-665-4549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Best Available Evidence Contact	Business Systems Analyst Sr		Hall	Barbara		1-313-225-6662					BHall@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	06/17/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Chief Financial Officer	Executive Vice President CFO	Mr.	Mozak	Paul	L	1-313-225-7939					pmozak@bcbsm.com	600 East Lafayette Blvd.	MC 2122	Detroit	MI	48226	01/11/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	CMS Casework Communication Contact	Business Analyst		Whitener	David		1-313-654-6885					DWhitener@bcbsm.com	1000 Town Center, Mail Code: TC1301		Southfield	MI	48075	09/08/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Coordination of Benefits Contact	Manager	Ms.	Lang	Michelle		1-313-225-5662					mlang@bcbsm.com	600 East Lafayette Blvd.	TC 1515	Detroit	MI	48226	10/16/2019	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Customer Service Operations Contact	Director	Ms.	Judson	Johanna		1-313-225-5856					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Government Relations Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Hospice Contact	Manager	Mrs.	Rawson	Lori		1-616-956-5796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/03/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Part D Exceptions Contact	Manager	Mr.	Petkoff	Ryan						1-800-459-8027	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/16/2020	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-437-3803				Medicare Prescription Drug Plan		5	Chicago
S5584	Pharmacy Network Management Contact	Director	Mr.	Perry	Glen	A	1-313-448-5949					gperry1@bcbsm.com	600 East Lafayette Blvd.	512H	Detroit	MI	48226	06/17/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5584	Pharmacy Technical Help Desk Contact	Mgr	Mr.	Nalamolu	Chandra							hnalamolu@bcbsm.com	600 East Lafayette Blvd	TC 1309	Detroit	MI	48226	01/04/2021	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Chicago
S5584	Plan to Plan Reconciliation Contact	Financial Coordinator		Jovanovska	Natasa		1-248-665-4558					njovanovska@bcbsm.com	600 East Lafayette Blvd.	Attn: P2P Mail Code 0807 -  S English	Detroit	MI	48226	06/17/2022	2023	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	PDP	Blue Cross Blue Shield of Michigan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Automated TrOOP Balance Transfer Contact	Analyst	Mr.	Klatt	Donni		1-419-887-2940				1-419-887-2020	Donni.Klatt@ProMedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Best Available Evidence Contact	Analyst	Mr.	Klatt	Donni		1-419-887-2917				1-419-887-2040	Donni.Klatt@ProMedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Chief Financial Officer	Chief Financial Officer	Mr.	Martin	Jeff		1-419-887-2959				1-419-887-2031	jeff.martin@promedica.org	300 Madison Ave. Suite 270	P.O. Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	CMS Casework Communication Contact	Member Services Team Leader	Ms.	Harper	Leslie		1-419-887-2410				1-419-887-2047	leslie.harper@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Coordination of Benefits Contact	Director Risk Adjustment & Recoveries	Ms.	Curry	Deborah		1-419-887-2215				1-419-887-2398	Deborah.Curry@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Customer Service Operations Contact	Operations Manager, Member Services	Ms.	Trivedi	Kyle		1-419-887-2424				1-419-887-2047	kyle.trivedi@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Government Relations Contact	Manager, Regulatory Affairs	Ms.	Beadle	Nicole		1-419-887-2859				1-419-887-2011	nicole.beadle@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Hospice Contact	Pharmacy Regulatory Compliance Coordinator	Mr.	Ingman	Brian		1-419-887-2204				1-567-585-9454	Brian.Ingman@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	12/28/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Medicare Compliance Officer	Manager, Regulatory Affairs	Ms.	Beadle	Nicole		1-419-887-2859				1-419-887-2011	nicole.beadle@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Part D Exceptions Contact	Senior Pharmacist	Mr.	Bogner	Craig	M					1-567-585-9454	craig.bogner@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active	1-800-462-3589				Medicare Prescription Drug Plan		5	Chicago
S5588	Pharmacy Network Management Contact	Senior Pharmacist	Mr.	Bogner	Craig	M	1-419-887-2249				1-567-585-9454	craig.bogner@promedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5588	Pharmacy Technical Help Desk Contact	Manager, Vendor Management	Mr.	Palmieri	Mike							Mike.Palmieri@Caremark.com	2401 Cherahala Blvd		Knoxville	TN	37932	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active	1-866-693-4620				Medicare Prescription Drug Plan		5	Chicago
S5588	Plan to Plan Reconciliation Contact	Sr. Analyst	Mr.	Elliott	Sean		1-419-887-2922				1-419-887-2020	Sean.Elliott@ProMedica.org	300 Madison Ave. Suite 270	P.O Box 928 Toledo, OH 43697	Toledo	OH	43604	11/04/2022	2023	PARAMOUNT INSURANCE COMPANY	PDP	Paramount Prescription Drug Plan	Medicare Prescription Drug Plan		Promedica Health System, Inc.	191	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5593	Automated TrOOP Balance Transfer Contact	Manager, Enrollment & Billing	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/05/2017	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		1-412-544-5689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Chief Financial Officer	CFO Highmark Health Plan	Mr.	Veach	Daryl		1-412-544-7531					Daryl.Veach@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/14/2021	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	1-412-544-4579				1-717-635-4209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/06/2020	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		1-412-544-4417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	12/26/2019	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		1-814-871-6712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/09/2020	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Government Relations Contact	SVP, Government Affiars	Mr.	Warfel	Michael	G	1-717-302-3979					michael.warfel@highmark.com	1800 Center St.		Camp Hill	PA	17011	03/18/2022	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Hospice Contact	Intake Coordinator		Welker	Jessica		1-717-888-3043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	10/25/2019	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		1-412-544-7031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/05/2017	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite P4207	Pittsburgh	PA	15222	11/14/2013	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	1-800-600-2227				Medicare Prescription Drug Plan		5	Philadelphia
S5593	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5593	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/09/2022	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Philadelphia
S5593	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	1-717-302-2748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 890407	Camp Hill	PA	17089-0407	02/01/2018	2023	HM HEALTH INSURANCE COMPANY	PDP	Highmark Inc.	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5596	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				Medicare Prescription Drug Plan		5	Chicago
S5596	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				Medicare Prescription Drug Plan		5	Chicago
S5596	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem / Anthem or Blue KC in Missouri	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5601	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		1-717-526-2745					jwhoffer@cvshealth.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17106-7103	01/10/2022	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Best Available Evidence Contact	Sr. Manager Enrollment Operations		Lisowski	Susan		1-480-298-6117				1-866-552-6205	Susan.Lisowski@CVSHealth.com	9501 E Shea Boulevard		Scottsdale	AZ	85260	05/04/2020	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Chief Financial Officer	Vice President, CFO, Medicare	Mr.	Grozio	Kevin		1-860-273-1068					Groziok@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/03/2020	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	CMS Casework Communication Contact	Director, Medicare Complaints		Diamond	Lorraine		1-724-778-5042				1-860-754-5693	cmscasework@aetna.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	05/21/2021	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Coordination of Benefits Contact	Manager, Med D Financial Reconciliation	Ms.	Viana	Silvia		1-480-298-0166					Silvia.Viana@CVSHealth.com	9501 E. Shea Blvd, MC121		Scottsdale	AZ	85260	05/04/2020	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Customer Service Operations Contact	Director Customer Care		Swanger	Rachel		1-440-542-4056					Rachel.Swanger@CVSHealth.com	29100 Aurora Road		Solon	OH	44139	11/04/2019	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	1-202-285-5320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/24/2022	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Hospice Contact	Sr, Manager, Medicare Part D Finance		Bernard	Alexander		1-480-243-5453				1-844-299-4547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 143		Scottsdale	AZ	85260	06/24/2022	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	1-480-661-2030				1-855-454-8052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Part D Exceptions Contact	Lead Dir., Medicare Quality and Audit		Brauner	Lyle							Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/24/2022	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active	1-602-618-3945				Medicare Prescription Drug Plan		5	Philadelphia
S5601	Pharmacy Network Management Contact	Exec Director, Strategic Programs		Bishel	Lynn	E	1-860-273-2196					bishell@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/03/2023	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5601	Pharmacy Technical Help Desk Contact	Sr.Director, Medicare Service Operations	Mr.	Howarth	James							JFHowarth@aetna.com	7034 Alamo Downs Pkwy		San Antonio	TX	78238	01/03/2023	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active	1-800-238-6279				Medicare Prescription Drug Plan		5	Philadelphia
S5601	Plan to Plan Reconciliation Contact	Manager, Financial Accounting Services	Ms.	Burkholder	Brianna		1-717-526-2860				1-724-741-7216	P2P@aetna.com	3721 TecPort Drive	PO Box 67103	Harrisburg	PA	17111	06/24/2022	2023	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S5609	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				Medicare Prescription Drug Plan		5	Seattle
S5609	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5609	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	1305 Corporate Center Dr	Eagan	MN	55121	01/29/2018	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				Medicare Prescription Drug Plan		5	Seattle
S5609	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5617	Automated TrOOP Balance Transfer Contact	Operations Advisor	Mrs.	Fertig	Nancy		1-860-902-4553					nancy.fertig@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Best Available Evidence Contact	Operations Senior Manager	Mrs	Rodrigue	Jacquelyn		1-860-226-4165					jacquelyn.rodrigue@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Greg		1-215-761-1880	1880				gregory.czar@cigna.com	1601 Chestnut St -Two Liberty		Philadelphia	PA	19192	08/30/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	CMS Casework Communication Contact	Customer Service Manager	Mrs.	Fischbach	Susan		1-804-904-6277					Susan.Fischbach@healthspring.com	3700 O'Donnell Street		Baltimore	MD	21224	01/07/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Coordination of Benefits Contact	Operations Senior Manager		Rodrigue	Jacquelyn		1-860-226-4165					jacquelyn.rodrigue@cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Customer Service Operations Contact	Operations Senior Manager	Mrs.	Weber	Ashleigh		1-860-902-9968					ashleigh.weber@cigna.com	900 Cottage Grove Rd		Bloomfield	CT	06512	03/15/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Government Relations Contact	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Hospice Contact	Operations Senior Manager		Rodrigue	Jacquelyn	P	1-860-226-4165					Jacquelyn.Rodrigue@Cigna.com	900 Cottage Grove Road		Bloomfield	CT	06512	12/15/2022	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ronald							ronald.erkens@cigna.com	25500 N Norterra Drive, Building B		Phoenix	AZ	85085	01/07/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active	1-480-548-0643				Medicare Prescription Drug Plan		5	New York
S5617	Pharmacy Network Management Contact	Provider Contract Manager	Mrs.	Bourdier	MaryAnne		1-860-904-4239					Maryanne.Bourdier@Cigna.com	500 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Pharmacy Technical Help Desk Contact			Scripts	Express								1 Express Way		St. Louis	MO	63121	01/01/2020	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	New York
S5617	Plan to Plan Reconciliation Contact			Thomas	Andrea		1-615-234-6766				1-615-291-7025	p2p@healthspring.com	PO BOX 11407	Dept#8277	Birmingham	AL	35246	05/06/2021	2023	CIGNA HEALTH AND LIFE INSURANCE COMPANY	PDP	Cigna	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Automated TrOOP Balance Transfer Contact	Director		Tierney	Dan		1-201-819-1561					ESITroopTransfer@express-scripts.com	100 Parsons Pond Dr.		Franklin Lakes	NJ	07417	12/30/2021	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Best Available Evidence Contact	Director		Tierney	Dan		1-201-819-1561					daniel_tierney@express-scripts.com	100 Parsons Pond Dr		Franklin Lakes	NJ	07417	12/30/2021	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Chief Financial Officer		Mr.	Phillips	Bradley		1-314-614-6784					BPhillips@express-scripts.com	One Express Way		St. Louis	MO	63121	03/17/2020	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	CMS Casework Communication Contact	Manager		Anderson	Angela		1-972-915-6108					angela_anderson@express-scripts.com	1707 Market Place Blvd	Suite 390	Irving	TX	75063	03/23/2021	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Coordination of Benefits Contact	Director		Proper	Rob		1-614-214-4681					MedDCOBTeam@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	04/08/2022	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Customer Service Operations Contact	Manager		Davidson	Regina		1-270-872-6503					Regina_Davidson@express-scripts.com	One Express Way		St. Louis	MO	63121	11/17/2021	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Government Relations Contact	Senior Principal - Federal Government Affairs		Michel	James		1-616-635-6537					James.Michel@Cigna.com	701 Pennsylvania Ave NW	Ste. 720	Washington	DC	20004	01/13/2022	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Hospice Contact	Product Management Manager		Holdren	Frank		1-614-390-9546					HP-HospiceBAE@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	05/23/2022	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Young	Thomas		1-615-429-5819					Thomas.Young@healthspring.com	530 Great Circle Road		Nashville	TN	37228	12/29/2021	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Exceptions Contact			Schumm	Brian							brian_schumm@express-scripts.com	5151 Blazer Parkway		Dublin	OH	43017	04/29/2021	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active	1-800-344-3405	733326			Medicare Prescription Drug Plan		5	New York
S5660	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/30/2016	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Pharmacy Technical Help Desk Contact	Director Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	11/17/2021	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	New York
S5660	Plan to Plan Reconciliation Contact	Accounting Senior Analyst		Tullock	Zachary		1-314-847-8133					Zachary.Tullock@express-scripts.com	One Express Way	Mailstop HQE04	Saint Louis	MO	63121	11/01/2022	2023	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		CIGNA	38	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5715	Automated TrOOP Balance Transfer Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		1-570-344-9237	73545			1-000-000-0000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		1-312-653-5482				1-000-000-0000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	11/06/2020	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Smith	Tawanna		1-630-824-5090				1-000-000-0000	Tawanna_Smith@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	12/08/2021	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Coordination of Benefits Contact	Director, PBM Operation	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Customer Service Operations Contact	AVP Medicare Program Mgmt	Ms.	Katsoulis	Kate		1-972-766-5122				1-000-000-0000	mohrk@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	02/05/2020	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Government Relations Contact	DVP Health Policy Government Programs	Ms.	Mott-Bronson	Dana		1-202-249-7214				1-000-000-0000	Dana_Mott-bronson@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	12/04/2018	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	1-505-816-2717				1-000-000-0000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	1-312-653-5110				1-312-819-9474	Kim_Green@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Part D Exceptions Contact	Regulatory Director	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/01/2021	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	1-800-693-6651				Medicare Prescription Drug Plan		5	Denver
S5715	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2022	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5715	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						1-000-000-0000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2022	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	1-800-693-6704				Medicare Prescription Drug Plan		5	Denver
S5715	Plan to Plan Reconciliation Contact	Accountant	Ms.	Nipabi	Ola		1-972-766-1324				1-972-766-4360	P2P_HCSCO@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	01/06/2022	2023	HCSC INSURANCE SERVICES COMPANY	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S5726	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Chief Financial Officer	Chief Financial Officer	Mr.	Bergman	Jeff		1-785-291-7263					jeff.bergman@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629-0001	06/01/2022	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Government Relations Contact	Chief Compliance Officer	Mr.	Roehler	Dan		1-785-291-8624					Compliance@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	66629-0001	11/16/2020	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Medicare Compliance Officer	Compliance Officer	Mrs.	Pewe	Michelle		1-785-291-6947				1-785-290-0701	Compliance@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	66629-0001	11/16/2020	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active	1-513-316-7654				Medicare Prescription Drug Plan		5	Kansas City
S5726	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5726	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active	1-833-377-4266				Medicare Prescription Drug Plan		5	Kansas City
S5726	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas or Blue KC	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Automated TrOOP Balance Transfer Contact			Mitchell	Angela		1-651-662-3607					Angela.Mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Best Available Evidence Contact			Davis	Thomas		1-570-344-9237	73545			1-570-344-9233	thomasdavis@cognizant.com	TMG Health	25 Lakeview Dr	Jessup	PA	18434	10/19/2018	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Chief Financial Officer		Ms	Ferlita	Carrie		1-651-662-9037					carrie.ferlita@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	CMS Casework Communication Contact			Blake	Tracy		1-651-662-3509					tracy.blake@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Coordination of Benefits Contact			Schmeling	Amy		1-651-662-4919					amy.schmeling@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Customer Service Operations Contact			Castle	Dina		1-651-662-2185					dina.castle@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Government Relations Contact	Vice President - Operations		Sheehan	Nancy		1-651-662-2701					nancy.sheehan@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Hospice Contact			Schmeling	Amy		1-651-662-4919				1-651-662-3500	Amy.Schmeling@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Medicare Compliance Officer	Compliance Officer	Mr	Happe	Paul	M	1-651-662-1234					paul.happe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/01/2022	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Part D Exceptions Contact			Ibrahim	Sonya							sonya.ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active	1-651-662-7412				Medicare Prescription Drug Plan		5	Kansas City
S5743	Pharmacy Network Management Contact	VP, Network Management		Conlin	Marci		1-612-777-2842				1-877-823-6373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/16/2022	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5743	Pharmacy Technical Help Desk Contact			Blake	Tracy							tracy.blake@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/19/2022	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active	1-800-858-0723				Medicare Prescription Drug Plan		5	Kansas City
S5743	Plan to Plan Reconciliation Contact			Voves	Alex		1-651-662-3606					Alex.Voves@clearstonesolutions.com	3535 Blue Cross Road		Eagan	MN	55122	03/30/2017	2023	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	PDP	MedicareBlue Rx	Medicare Prescription Drug Plan		BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	28	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5795	Automated TrOOP Balance Transfer Contact	Eligibility Supervisor		White	William		1-612-777-6736					eobp2p@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	11/08/2018	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Best Available Evidence Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Chief Financial Officer	CFO	Mr.	Winter	Scott		1-501-399-3951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	CMS Casework Communication Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Coordination of Benefits Contact	Eligibility Supervisor		White	William		1-612-777-6736					cobmedd@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Drive		Eagan	MN	55121	11/08/2018	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Customer Service Operations Contact	Manager, Senior Products		Sherer	Michael		1-501-378-3641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	04/04/2022	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Government Relations Contact	Sr Counsel Gov't Relation		Fenton	Janie		1-501-378-2103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/28/2019	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		1-501-378-3743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Fenske	Anjenette		1-501-244-6350					amfenske@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/10/2020	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Part D Exceptions Contact			Review Audit & Regul	Clinical						1-800-693-6703	clinicalreviewclientinquiries@primetherapeutics.co	Centennial Crossings - Clinical Review 4401 West 76th S		Edina	MN	55435	11/08/2018	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active	1-800-693-6651				Medicare Prescription Drug Plan		5	Dallas
S5795	Pharmacy Network Management Contact	Senior Director Network Provider Relations		Grindsteinner	Bretta		1-612-777-4021					bgrinsteinner@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	12/16/2015	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5795	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	Prime						1-888-285-2242	MGarzarodriguez@primetherapeutics.com	Prime Therapeutics LLC 1305 Corporate Center Dr		Eagan	MN	55121	04/15/2019	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active	1-800-693-3815				Medicare Prescription Drug Plan		5	Dallas
S5795	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		1-501-399-3958				1-501-378-3258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	07/05/2019	2023	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5805	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/12/2018	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Medicare Prescription Drug Plan		5	San Francisco
S5805	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5805	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Medicare Prescription Drug Plan		5	San Francisco
S5805	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/12/2018	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Medicare Prescription Drug Plan		5	San Francisco
S5820	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5820	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Medicare Prescription Drug Plan		5	San Francisco
S5820	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5857	Automated TrOOP Balance Transfer Contact	Enrollment Coordinator		Rice	Lori		1-616-464-8667					PH-MedicareTrOOPContact@PriorityHealth.com	1231 East Beltline Ave NE	MS 1175	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Best Available Evidence Contact	Manager, Medicare Enrollment		Thomas	Sabrina		1-616-464-8578					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Chief Financial Officer	Chief Financial Officer	Mr	Gates	Nick	P	1-616-464-8144					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	CMS Casework Communication Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		1-917-841-7869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/14/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Coordination of Benefits Contact	Claims Manager		Ball	Jill		1-888-389-6648					CEOMedicare@priorityhealth.com	1239 East Beltline Ave NE	MS2205	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Customer Service Operations Contact	Customer Care Center Manager, Medicare		Storment	Joe		1-503-330-9550					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/07/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Government Relations Contact	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Hospice Contact	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					CEOMedicare@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Medicare Compliance Officer	Medicare Compliance Officer	Mr	Baker	Charles		1-616-464-8824					charles.baker@priorityhealth.com	1231 East Beltline Ave NE	MS 1155	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Part D Exceptions Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	1-800-466-6642				Medicare Prescription Drug Plan		5	Chicago
S5857	Pharmacy Network Management Contact	Director Pharmacy Operations		Chaffee	Jacob		1-616-575-6149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5857	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	1-800-466-6642				Medicare Prescription Drug Plan		5	Chicago
S5857	Plan to Plan Reconciliation Contact	Reconciliation & Billing Specialist		Bentley-Brown	Linda		1-616-464-8582				1-616-957-3420	linda.bentley-brown@priorityhealth.com	1231 East Beltline Ave NE	MS 1190	Grand Rapids	MI	49525	12/06/2022	2023	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5877	Automated TrOOP Balance Transfer Contact	Director, Pharmacy and Medicare Services	Mr.	Gedge	Nathan		1-801-270-2974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Best Available Evidence Contact	Director, Pharmacy and Medicare Services	Mr.	Gedge	Nathan	D	1-801-270-2974				1-801-269-9734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Chief Financial Officer	Chief Financial Officer	Mr.	Greenhalgh	Mike		1-801-262-7476					mgreenhalgh@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	CMS Casework Communication Contact	Director, Pharmacy and Medicare Services		Gedge	Nate		1-801-270-2974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Coordination of Benefits Contact	Director, Pharmacy and Medicare Services		Gedge	Nate		1-801-270-2974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Customer Service Operations Contact	Sr. Manager - Contact Center		Bloomfield	Peggy		1-772-236-2738					Peggy_Bloomfield@Express-Scripts.com	10045 South Federal Highway		Port St. Lucie	FL	34952	03/30/2017	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Government Relations Contact	Director, Pharmacy and Medicare Services		Gedge	Nate		1-801-270-2974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Hospice Contact	Director of Pharmacy and Medicare Services	Mr.	Gedge	Nathan		1-801-270-2974				1-801-269-9734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Medicare Compliance Officer	Compliance Officer	Mr.	Smart	Brandon		1-801-270-2981					bsmart@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian							brian_schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/08/2016	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active	1-614-336-3326				Medicare Prescription Drug Plan		5	Dallas
S5877	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	03/30/2017	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5877	Pharmacy Technical Help Desk Contact	Director - Contact Center		Roberts	Robin							RRoberts2@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	06/16/2017	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Dallas
S5877	Plan to Plan Reconciliation Contact			Clark	Anthony		1-801-262-7476	2965				aclark@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2023	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5884	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Best Available Evidence Contact	Manager, Enrollment		Woods	Byron		1-502-580-6016					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	CMS Casework Communication Contact	Manager		Hanke	Cindy		1-920-337-5667					HumanaCTMCasework@humana.com	1100 Employers Blvd		Green Bay	WI	54344	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		1-502-476-9797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	1-502-580-9138				Medicare Prescription Drug Plan		5	Kansas City
S5884	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		1-502-580-0475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	1-800-865-8715				Medicare Prescription Drug Plan		5	Kansas City
S5884	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	HUMANA INSURANCE COMPANY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5904	Automated TrOOP Balance Transfer Contact	Manager, PBM operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/27/2020	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Best Available Evidence Contact	Sr. Director EMB		Chick	Benjamin		1-904-905-1711					benjamin.chick@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	07/16/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Chief Financial Officer	SVP and CFO	Mr.	Justice	Thurman		1-904-905-5085					Thurman.Justice@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 8th Floor	Jacksonville	FL	32246	08/21/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	CMS Casework Communication Contact	Sr Manager Business Support		Stewart	Delores		1-904-905-0558					Delores.Stewart@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	07/17/2020	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Coordination of Benefits Contact	Manager PBM Operations		Hanson	Michelle		1-612-777-6755				1-312-777-6706	COBMedD@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	02/16/2021	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Customer Service Operations Contact	Sr Director Member Contact		Gamble	LaTonya		1-904-905-2057					latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Government Relations Contact	Sr Director Govt Programs & Products Compliance		Simpson	Hillary		1-904-445-8502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	12/29/2021	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Hospice Contact	Pharmacist- Govt Pharmacy Prg		Adams	Tangela		1-904-905-0002					tangela.adams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 5th Floor	Jacksonville	FL	32246	01/22/2018	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Medicare Compliance Officer	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		1-904-445-8502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Part D Exceptions Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active	1-800-477-3736	56307			Medicare Prescription Drug Plan		5	Atlanta
S5904	Pharmacy Network Management Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		1-904-905-6307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 900, 4th Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5904	Pharmacy Technical Help Desk Contact	Director, Member Services		Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	07/19/2021	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active	1-888-877-6420				Medicare Prescription Drug Plan		5	Atlanta
S5904	Plan to Plan Reconciliation Contact	Accounting Specialist		Williams	Lynn		1-904-905-4568					lynn.williams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	01/04/2019	2023	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5916	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		1-612-777-6755				1-612-777-6706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Best Available Evidence Contact	Membership Ambassador	Ms.	Neufeld	Jeri		1-800-662-1470	2526			1-888-335-2988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	02/16/2018	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Chief Financial Officer	EVP & CFO	Mr.	Price	Vince		1-503-225-4892					vpprice@regence.com	200 SW Market St	M/S E15A	Portland	OR	97201	11/13/2015	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	CMS Casework Communication Contact	Appeals Specialist	Ms.	Aime	Cathleen		1-866-749-0355	2653			1-888-309-8784	cathleen.aime@regence.com	M/S: B32AG	PO Box 1827	Medford	OR	97501	10/01/2014	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Coordination of Benefits Contact	Manager, Member Services	Ms	Christiansen	Stacy		1-541-618-1240					Stacy.Christiansen@regence.com	PO Box 1827	MS: B32M	Medford	OR	97501	07/09/2016	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Customer Service Operations Contact	Manager Member Services	Ms	Ciuro	Catina		1-541-618-1268					Catina.Ciuro@regence.com	2057 Commerce Dr		Medford	OR	97504	02/07/2019	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Government Relations Contact	GM Government Programs		Faulk	Kathleen		1-503-225-5408					Kathleen.Faulk@regence.com	200 SW Market St.	MS:E10M	Portland	OR	97201	09/13/2017	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Hospice Contact	Pharmacy Ops Oversight Specialist	Ms.	Pickens	Spring		1-503-225-5240					Spring.Pickens@regence.com	100 SW Market St	MS: WW5-56	Portland	OR	97201	02/05/2018	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Del Villar	Jennifer		1-503-220-6237					Jennifer.DelVillar@cambiahealth.com	200 SW Market St	MS: E10C	Portland	OR	97201	07/14/2022	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Part D Exceptions Contact	Director, Regulatory and Audit Response	Ms.	Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	09/11/2020	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	1-612-777-5393				Medicare Prescription Drug Plan		5	Seattle
S5916	Pharmacy Network Management Contact	AVP, Network Mangement	Ms.	Conlin	Marci		1-612-777-2842				1-877-823-6373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2020	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5916	Pharmacy Technical Help Desk Contact	Director, Member Services Government Programs	Mr.	Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2020	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	1-844-765-6826				Medicare Prescription Drug Plan		5	Seattle
S5916	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		1-503-225-5368					Amy.Manzer@regence.com	200 SW Market St	M/S: PDX-ZOF WW3-33	Portland	OR	97201	08/26/2021	2023	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	PDP	Regence BlueShield of Idaho and Regence BC BS Utah	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5921	Automated TrOOP Balance Transfer Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Best Available Evidence Contact			Prince	Shelli		1-715-858-5748					bae_requests@uhc.com	2725 Mall Drive		Eau Claire	WI	54701	05/19/2021	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Chief Financial Officer		Mr.	Eklo	Benjamin		1-952-931-4168					benjamin_n_eklo@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/21/2022	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	CMS Casework Communication Contact			Ojeda	Iris		1-952-202-6682					iris.vasquez@uhc.com	PO Box 9472		Minneapolis	MN	55440-9472	04/12/2018	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Coordination of Benefits Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Customer Service Operations Contact			Thomas	Gary		1-210-474-5488					blake_thomas@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	04/09/2021	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Government Relations Contact			Tarvestad	Katherine		1-952-931-5444					kate.tarvestad@uhc.com	2020 Innovation Court		De Pere	WI	54115	12/20/2021	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Hospice Contact			Scally	Michael		1-443-896-1222					mike_scally@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Medicare Compliance Officer		Ms.	Tarvestad	Katherine		1-952-931-5444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/28/2019	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Part D Exceptions Contact			Busbee	Nathanael							nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	1-443-896-1223				Medicare Prescription Drug Plan		5	San Francisco
S5921	Pharmacy Network Management Contact			Busbee	Nathanael		1-443-896-1223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5921	Pharmacy Technical Help Desk Contact			Busbee	Nathanael								10175 Little Patuxent Parkway		Columbia	MD	21044	05/07/2020	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	1-877-889-6510				Medicare Prescription Drug Plan		5	San Francisco
S5921	Plan to Plan Reconciliation Contact			Crone	David		1-952-931-5204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	60197-5818	01/02/2020	2023	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S5953	Automated TrOOP Balance Transfer Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Best Available Evidence Contact	Director Operations		Ortiz	Jason		1-803-264-3910				1-803-264-9581	Jason.Ortiz@bcbssc.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Chief Financial Officer	VP & CFO, BCBS Div	Mrs.	Srulevich	Heather		1-803-264-9488					Heather.Srulevich@BCBSSC.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	10/26/2017	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	CMS Casework Communication Contact	Manager - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Coordination of Benefits Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		1-803-264-1103					Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Customer Service Operations Contact	Director Operations		Ortiz	Jason		1-803-264-3910					jason.ortiz@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/11/2020	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Government Relations Contact	Compliance Officer		Pierstorff	Joel		1-803-264-1971				1-803-264-4050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Hospice Contact			DeWitt	Tanika		1-803-264-1103					tanika.dewitt@bcbssc.com	1-20 @ Alpine Rd. AX-155		Columbia	SC	29223	04/11/2018	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Medicare Compliance Officer	Compliance Officer	Mr.	Pierstorff	Joel		1-803-264-1971				1-803-264-4050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	01/05/2022	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Part D Exceptions Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris						1-803-870-8162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/22/2016	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active	1-803-264-4347				Medicare Prescription Drug Plan		5	Atlanta
S5953	Pharmacy Network Management Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		1-803-264-4347				1-803-870-8162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/22/2016	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5953	Pharmacy Technical Help Desk Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris							Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/31/2019	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active	1-855-540-5951				Medicare Prescription Drug Plan		5	Atlanta
S5953	Plan to Plan Reconciliation Contact	Banking Supervisor		Craft	Jennifer		1-803-264-3430				1-803-870-8623	EFT.Request@bcbssc.com	I-20 at Alpine Road	AX-A30	Columbia	SC	29219	11/12/2015	2023	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan		BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5960	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				Medicare Prescription Drug Plan		5	Chicago
S5960	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				Medicare Prescription Drug Plan		5	Chicago
S5960	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	UNICARE LIFE & HEALTH INSURANCE COMPANY	PDP	UniCare	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5966	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		1-860-674-5780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	06/25/2021	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Best Available Evidence Contact	Manager, Vendor Operations		Ewen	Jillian		1-860-674-5780					jewen@connecticare.com	175 Scott Swamp Road	P.O. Box 4050	Farmington	CT	06034-4050	03/23/2020	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		1-646-447-6174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	07/02/2020	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	CMS Casework Communication Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	1-646-447-7215				1-212-510-8130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	07/25/2022	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Coordination of Benefits Contact	Sr. Dir., Claims Operations & Provider Data Mgmt		Gauthier	Kathleen	H	1-860-409-6435					kgauthier@connecticare.com	55 Water Street		New York	NY	10041	07/15/2021	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Customer Service Operations Contact	VP, Ops Strategy & Service Delivery		Pandey	Priyank		1-646-447-7543					ppandey@emblemhealth.com	55 Water Street		New York	NY	10041	02/17/2021	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Government Relations Contact	Director, Medicare Compliance		Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/09/2019	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Hospice Contact	Senior Medicare Pharmacy Specialist		Der Weer	J'Nisha		1-646-447-7198					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2022	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Borenkind	Carly		1-646-447-7141					cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	05/08/2019	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Exceptions Contact	Director		Colby	Andrew							acolby@emblemhealth.com	55 Water street		New York	NY	10041	05/12/2022	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active	1-646-447-3340				Medicare Prescription Drug Plan		5	New York
S5966	Pharmacy Network Management Contact	Pharmacy Client Ops Director		Brown	Gregory		1-401-525-1683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2022	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	6625 West 78th street		Bloomington	MN	55439	03/08/2022	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active	1-800-922-1557	2			Medicare Prescription Drug Plan		5	New York
S5966	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		1-646-447-3017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	08/16/2022	2023	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth Medicare PDP	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5975	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/04/2020	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Best Available Evidence Contact	Supervisor Membership Accounting		Black	Colby		1-503-265-5606					colby.black@modahealth.com	601 SW 2nd Avenue		Portland	OR	97204	04/01/2022	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Chief Financial Officer	Sr VP CFO	Mr.	Evans	Dave		1-503-243-3952				1-503-948-5557	dave.evans@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	07/11/2018	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	CMS Casework Communication Contact	Lead Appeals Coordinator	Ms.	Shattuck	Mica		1-503-412-4021				1-833-949-1888	mica.shattuck@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/11/2020	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Coordination of Benefits Contact			Service	Customer		1-877-299-9062				1-503-948-5577	PharmacyMedicare@modahealth.com	PO Box 40327		Portland	OR	97240	04/19/2022	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Customer Service Operations Contact	Customer Service Manager	Ms.	Duncan	Colleen		1-503-765-3424					colleen.duncan@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	02/11/2019	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Government Relations Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		1-503-952-5075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Hospice Contact	Rx Government Programs Analyst	Mr.	Beebe	Colin		1-503-412-4175	4175			1-800-207-8235	colin.beebe@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	06/04/2020	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	McWhorter	Gary		1-503-952-5075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Part D Exceptions Contact	Pharmacy, Customer Service		Service	Customer						1-800-207-8235	PharmacyMedicare@modahealth.com	601 S.W. Second Ave.		Portland	OR	97204	01/25/2017	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active	1-888-786-7509				Medicare Prescription Drug Plan		5	Seattle
S5975	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@navitus.com	361 Integrity Drive		Madison	WI	53717	03/31/2022	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5975	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						1-920-221-4724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/04/2020	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active	1-866-270-3877	4224			Medicare Prescription Drug Plan		5	Seattle
S5975	Plan to Plan Reconciliation Contact	Lead Pharmacy Benefit Formulary Coordinator	Ms	Brokaw	Katie		1-503-265-4771	4771				katie.brokaw@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	10/29/2019	2023	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5993	Automated TrOOP Balance Transfer Contact	Director, PBM Ops.	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	09/28/2022	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Best Available Evidence Contact	Supervisor, Govt.. Programs		Achoe	Kisha		1-973-466-7328					BAEINQUIRIES@horizonblue.com	3 Penn Plaza East, PP-12L		Newark	NJ	07105	07/31/2018	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Chief Financial Officer	SVP & Chief Financial Offcr.	Mr.	Rosenberg	David		1-973-466-4600					david_rosenberg@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/02/2022	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	CMS Casework Communication Contact	Director, GP Operations		Maramraju	Venkata		1-609-537-2113					venkata.maramraju@horizonblue.com	1700 American Boulevard		Pennington	NJ	08534	01/03/2022	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Coordination of Benefits Contact	Director, PBM Ops	Ms.	Allie	Cindy		1-612-777-6722				1-612-777-6706	COBMedD@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	09/28/2022	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Customer Service Operations Contact	Director, Service Operations	Mr.	Yanek	John		1-518-220-8000					john_yanek@horizonblue.com	3 Penn Plaza		Newark	NJ	07105	06/13/2022	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Government Relations Contact	Director, Regulatory Compliance/ MCO	Mr.	McGrady	Daniel		1-732-539-3680					daniel_mcgrady@horizonblue.com	1700 American Blvd.	HL-03	Pennington	NJ	08534	02/25/2022	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Hospice Contact	Manager, Clinical Pharmacy		Sun	Jane		1-973-466-5044					Jane_Sun@horizonblue.com	3 Penn Plaza	12-Q	Newark	NJ	07105	02/15/2018	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Medicare Compliance Officer	Director, Reg. Requirements/ MCO	Mr	McGrady	Daniel		1-732-539-3680					daniel_mcgrady@horizonblue.com	1700 American Blvd.	HL-03	Pennington	NJ	08534	07/12/2021	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Part D Exceptions Contact	Director, Reg/Audit Response	Ms.	Davis	Megan						1-800-693-6703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd		Eagan,	MN	55121	04/15/2021	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active	1-800-693-6651				Medicare Prescription Drug Plan		5	New York
S5993	Pharmacy Network Management Contact	AVP, Network Mgmt	Ms	Conlin	Marci		1-612-777-2842					Marci.Conlin@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	04/15/2021	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5993	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	PRIME Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	09/28/2022	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active	1-800-391-1926				Medicare Prescription Drug Plan		5	New York
S5993	Plan to Plan Reconciliation Contact	Pharmacy Business Admin		Cunningham	Theresa		1-973-466-7886				1-973-466-4665	theresa_cunningham@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	10/14/2016	2023	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active					Medicare Prescription Drug Plan		5	New York
S6506	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		1-858-790-6250					PartDCAT@medimpact.com	MedImpact Healthcare Systems, Inc.	10181 Scripps Gateway Ct	San Diego	CA	92131	12/30/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Best Available Evidence Contact	Medicare Part D Program Manager III		Gaynor	Donna		1-858-790-7458					donna.gaynor@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Chief Financial Officer	Senior Vice President and CFO	Mr.	El-Tawil	Mark		1-602-864-5700					Mark.El-Tawil@azblue.com	Blue Cross and Blue Shield of Arizona	2444 W. Las Palmaritas Drive	Phoenix	AZ	85021	10/11/2018	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	CMS Casework Communication Contact	Director, PDP Operations		Bossert	Michele		1-858-790-6323					Michele.Bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Coordination of Benefits Contact	Medicare Part D Program Manager I		Williams	Valencia		1-858-790-3028					valencia.williams@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/18/2022	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Customer Service Operations Contact	Director, PDP Operations		Bossert	Michele		1-858-790-6323					Michele.Bossert@medimpact.com	MedImpact Healthcare Systems, Inc.	10181 Scripps Gateway Ct	San Diego	CA	92131	12/21/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Government Relations Contact	VP & General Manager Medicare & FEP	Mr.	Ladich	Matt		1-480-303-4439					matthew.ladich@azblue.com	8220 N. 23rd Ave.		Phoenix	AZ	85021	08/19/2021	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Hospice Contact	Medicare Part D Program Manager III		Meade	Karen		1-858-790-6121					karen.meade@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/30/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Medicare Compliance Officer	Director, Corporate and Medicare Compliance	Mrs.	Moore	Veronica		1-602-336-7600				1-602-864-3152	veronica.moore@azblue.com	8220 N 23rd Avenue		Phoenix	AZ	85021	02/11/2021	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Part D Exceptions Contact	Director, PDP Operations		Bossert	Michele							Michele.Bossert@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/30/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-858-790-6323				Medicare Prescription Drug Plan		5	San Francisco
S6506	Pharmacy Network Management Contact	Dir - Clinical Pharmacy Program		Weideman	Stacy		1-602-864-4391					stacy.weideman@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	12/16/2022	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6506	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/15/2021	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active	1-833-229-3593				Medicare Prescription Drug Plan		5	San Francisco
S6506	Plan to Plan Reconciliation Contact	Director, Financial Reporting		Acquafredda	Brandy		1-602-864-4683					brandy.acquafredda@azblue.com	PO Box 81049		Phoenix	AZ	85069	12/14/2020	2023	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	PDP	Blue Cross Blue Shield of Arizona	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Arizona	447	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S6875	Automated TrOOP Balance Transfer Contact	Pharmacy Services Manager		Parisi	Dana		1-215-241-3265				1-215-241-3526	Dana.Parisi@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	02/26/2015	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Best Available Evidence Contact	Sr. Business Analyst		Caldwell	Geraldine		1-267-675-1809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Chief Financial Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		1-215-241-4614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	CMS Casework Communication Contact	Manager, Medicare Operations		Zonies	Melissa		1-267-675-1633					Melissa.Zonies@ibx.com	1901 Market Street, 11th Floor		Philadelphia	PA	19103	10/31/2016	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Coordination of Benefits Contact	Manager, COB/OPL		Hawkins	Veronica		1-215-640-7507	27507				Veronica.Hawkins@ibx.com	1901 Market Street	17th Floor	Philadelphia	PA	19103	12/24/2020	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Customer Service Operations Contact	Director, Contact Center		Lentz	Michael		1-215-793-3262	63262				michael.lentz@ibx.com	1900 Market Street	5th Floor	Philadelphia	PA	19103	11/01/2022	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Government Relations Contact	Director of Regulatory Performance Management		Wyka	Tara		1-215-241-3648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Hospice Contact	Manager Pharmacy Compliance		Wells	Erika		1-215-241-3596					Erika.Wells@ibx.com	1901 Market St.	29th Floor	Philadelphia	PA	19103	11/29/2021	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Medicare Compliance Officer	Dir,Corp. Compl, Privacy & Medicare Compl Officer	Mr.	Goldberg	Mitchell		1-215-241-9516				1-215-567-4542	Mitchell.Goldberg@ibx.com	1901 Market Street		Philadelphia	PA	19103	02/28/2020	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Part D Exceptions Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						1-215-241-3526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active	1-888-678-7015				Medicare Prescription Drug Plan		5	Philadelphia
S6875	Pharmacy Network Management Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		1-215-241-2654				1-215-241-3526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6875	Pharmacy Technical Help Desk Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						1-215-241-3526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active	1-888-678-7015				Medicare Prescription Drug Plan		5	Philadelphia
S6875	Plan to Plan Reconciliation Contact	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		1-215-640-7265				1-215-241-2408	geoffrey.wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	02/18/2022	2023	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S6946	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Best Available Evidence Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Chief Financial Officer	Chief Financial Officer	Mr.	Littman	Harvey		1-224-985-5593				1-847-692-3225	harvey.littman@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	CMS Casework Communication Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Coordination of Benefits Contact	Senior Vice President, Operations	Mr.	Hebert	Bryan		1-813-285-6735					Bryan.Hebert@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Customer Service Operations Contact	Senior Director, Enrollment & Member Services	Ms.	Velez	Jessica		1-754-208-5865					Jvelez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Government Relations Contact	Chief Executive Officer and President	Mr.	Carlos	Art		1-847-696-8510					arthur.carlos@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	08/25/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Hospice Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		1-754-208-5867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Medicare Compliance Officer	Vice President, Compliance	Ms.	Cornish	Sameria		1-843-276-1153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Part D Exceptions Contact			Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2020	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active	1-614-336-3326				Medicare Prescription Drug Plan		5	Chicago
S6946	Pharmacy Network Management Contact			Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2020	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6946	Pharmacy Technical Help Desk Contact			Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	13051 N. Telecom Pkwy		Temple Terrace	FL	33637	11/19/2021	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Chicago
S6946	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		1-224-985-5588					Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	08/25/2022	2023	CLEAR SPRING HEALTH INSURANCE COMPANY	PDP	Clear Spring Health	Medicare Prescription Drug Plan		Group 1001	689	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S7126	Automated TrOOP Balance Transfer Contact	Senior Project Manager		Rush	Jamie		1-314-354-1103					ESITroopTransfer@express-scripts.com	One Express Way		St. Louis	MO	63121	04/14/2020	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Best Available Evidence Contact	Director		Simon	Blake		1-214-620-7186					blake_simon@express-scripts.com	1707 Market Place Blvd		Irving	TX	75063	10/19/2018	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Hrabchak	Rick		1-402-350-2503					richard.hrabchak@mutualofomaha.com	3300 Mutual of Omaha Plaza		Omaha	NE	68175	08/29/2019	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	CMS Casework Communication Contact	Director		Simon	Blake		1-214-620-7186					blake_simon@express-scripts.com	1707 Market Place Blvd. Suite 390		Irving	TX	75063	02/08/2018	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Coordination of Benefits Contact	Director		Tierney	Dan		1-201-269-5234					daniel_tierney@express-scripts.com	100 Parsons Pond Dr		Franklin Lakes	NJ	07417	02/09/2018	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Customer Service Operations Contact	Manager		Davidson	Regina		1-772-236-2766					Regina_Davidson@express-scripts.com	10045 South Federal Highway		Port St. Lucie	FL	34952	04/14/2020	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Government Relations Contact	Vice President		Nolan	Jim		1-402-351-2944					jim.nolan@mutualofomaha.com	3300 Mutual of Omaha Plaza		Omaha	NE	68175	02/09/2018	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Hospice Contact	Director		Simon	Blake		1-214-620-7186					blake_simon@express-scripts.com	1707 Market Place Blvd. Suite 390		Irving	TX	75063	02/09/2018	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Medicare Compliance Officer	Director of Medicare Compliance	Ms.	Hageman	Nichole		1-402-351-1516					nichole.hageman@mutualofomaha.com	3300 Mutual of Omaha Plaza		Omaha	NE	68175	02/10/2022	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							brian_schumm@express-scripts.com	5151 Blazer Parkway		Dublin	OH	43017	04/14/2020	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active	1-614-336-3326				Medicare Prescription Drug Plan		5	Kansas City
S7126	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		1-314-692-1866				1-877-387-5800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	04/14/2020	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7126	Pharmacy Technical Help Desk Contact	Director of Operations, Contact Center		Liu	Ian							iliu@express-scripts.com	6625 West 78th Street		Minneapolis	MN	55439	04/14/2020	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Kansas City
S7126	Plan to Plan Reconciliation Contact	Manager, Health Plan Finance	Ms.	Williams	Kliopetra		1-314-209-3068					klwilliams@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/03/2020	2023	OMAHA HEALTH INSURANCE COMPANY	PDP	Mutual of Omaha Rx	Medicare Prescription Drug Plan		Mutual of Omaha Insurance Company	699	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S7694	Automated TrOOP Balance Transfer Contact	Manager Medicare Enrollment		Desai	Mahadev		1-469-995-1443					mdesai@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Best Available Evidence Contact	Manager Medicare Enrollment		Desai	Mahadev		1-469-995-1443					mdesai@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Chief Financial Officer	CFO	Mr.	Greenblatt	Rand		1-856-230-3242					rgreenblatt@elixirsolutions.com	30 Hunter Lane		Camp Hill	PA	17011	09/28/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	CMS Casework Communication Contact	Senior Manager		Almer	Cassandra		1-916-941-3577					calmer@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Coordination of Benefits Contact	Senior Manager		Almer	Cassandra		1-916-941-3577					COB@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Customer Service Operations Contact	SVP,  Government Programs	Mr.	Goodson	David		1-720-252-9000					dgoodson@elixirsolutions.com	347 Washington Ave		Wilmette	IL	60091	09/19/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Government Relations Contact	Senior Medicare Compliance Officer	Mr.	O'Donnell	Dan		1-916-759-9401					dodonnell@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Hospice Contact	SVP,  Government Programs	Mr.	Goodson	David		1-720-252-9000					dgoodson@elixirsolutions.com	347 Washington Ave		Wilmette	IL	60091	09/19/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Medicare Compliance Officer	Senior Medicare Compliance Officer	Mr.	O'Donnell	Dan		1-916-759-9401					dodonnell@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Part D Exceptions Contact	SVP,  Government Programs	Mr.	Goodson	David							dgoodson@elixirsolutions.com	347 Washington Ave		Wilmette	IL	60091	09/19/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active	1-720-252-9000				Medicare Prescription Drug Plan		5	Dallas
S7694	Pharmacy Network Management Contact	AVP Provider Relations and Network Development	Mr.	Dyer	Tim		1-330-486-4812					tdyer@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S7694	Pharmacy Technical Help Desk Contact	VP of Operations		Conn	Todd						1-330-486-8081	tconn@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active	1-866-250-2005				Medicare Prescription Drug Plan		5	Dallas
S7694	Plan to Plan Reconciliation Contact	Manager, Group Billing		Mascia	Angelo	A	1-330-486-4845				1-330-486-4898	p2prec@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	11/23/2022	2023	ELIXIR INSURANCE COMPANY	PDP	Elixir Insurance	Medicare Prescription Drug Plan		Rite Aid Corporation	627	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S8067	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Best Available Evidence Contact	Manager, Medicare Enrollment, Billing & Recon	Ms.	Peterson	Nicole		1-717-541-6419				1-717-346-5811	nicole.peterson@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/08/2021	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Chief Financial Officer	Chief Financial Officer	Mr.	Woodard	Ralph		1-717-541-7181					ralph.woodard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/24/2021	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	CMS Casework Communication Contact		Ms.	Drawbaugh	Cindy		1-717-541-6257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/16/2022	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Coordination of Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Customer Service Operations Contact	Director Medicare Operations	Mr.	Koch	Jonathan		1-717-829-2114				1-717-651-8873	jonathan.koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	06/17/2020	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Government Relations Contact	Sr. VP & General Counsel	Mr.	Hopkins	Joel		1-717-541-6358				1-717-651-4445	Joel.Hopkins@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	07/19/2021	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Hospice Contact	Sr. Director Pharmacy and Clinical Svcs	Ms.	Leedock	Melissa		1-717-541-6934				1-717-651-4850	Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Yu	Gloria		1-717-541-7278					Gloria.Yu@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/09/2022	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Part D Exceptions Contact	Senior Director, Medicare Pharmacy Operations	Ms	Leedock	Melissa							Melissa.Leedock@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	12/14/2020	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active	1-866-987-4213				Medicare Prescription Drug Plan		5	Philadelphia
S8067	Pharmacy Network Management Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		1-717-703-8749				1-717-346-6836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8067	Pharmacy Technical Help Desk Contact	Director, Member Services	Ms	Pretlow	Jennifer							jennifer.pretlow@primetherapeutics.com	Prime Therapeutics LLC 2655 Eagan Woods Drive		Eagan	MN	55122	09/08/2021	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active	1-888-878-0151				Medicare Prescription Drug Plan		5	Philadelphia
S8067	Plan to Plan Reconciliation Contact	Accountant I	Ms.	Beauduy	Tamara		1-717-541-6946					FinanceP2P-CASH@CapBlueCross.com	2500 Elmerton Avenue	Mail Drop 3237	Harrisburg	PA	17177	08/16/2021	2023	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Philadelphia
S8182	Automated TrOOP Balance Transfer Contact	Director II Membership		Nunez	Lupe		1-303-290-3467					lupe.nunez@anthem.com	700 Broadway	Mail Drop CO0106-0601	Denver	CO	80273	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Best Available Evidence Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	05/10/2021	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Chief Financial Officer	Vice President, Finance Medicare	Mr.	Rains	Michael		1-317-646-4319					michael.rains@anthem.com	7364 Lesley Ave.		Indianapolis	IN	46250	06/21/2021	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		1-513-649-7052				1-888-458-1406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/01/2021	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		1-502-548-1076					beth.franke@anthem.com	13550 Triton Office Park Blvd		Louisville	KY	40223	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Customer Service Operations Contact	Director I, Customer Care		Villanueva	Graciela		1-346-718-0156					graciela.villanueva2@elevancehealth.com	5959 Corporate Drive		Houston	TX	77036	08/23/2022	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Hospice Contact	Manager I, Membership		Palfy	Roxanne		1-303-869-3337					Roxanne.palfy@anthem.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	03/15/2022	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		1-813-295-1367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	09/22/2022	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/03/2021	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	1-513-316-7654				Medicare Prescription Drug Plan		5	Chicago
S8182	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		1-805-405-3246					raymond.warner@ingenio-rx.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2021	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8182	Pharmacy Technical Help Desk Contact	raymond.warner@anthem.com		Warner	Raymond							raymond.warner@ingenio-rx.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	06/13/2022	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	1-833-377-4266				Medicare Prescription Drug Plan		5	Chicago
S8182	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		1-805-713-1098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2023	AMERIGROUP INSURANCE COMPANY	PDP	Amerigroup	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8841	Automated TrOOP Balance Transfer Contact	Manager, Business Process	Mr.	Diaz	Mario		1-949-475-3517					mario.diaz@optum.com	1100 Optum Circle		Eden Prairie	MN	55344	05/26/2017	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Best Available Evidence Contact	Director, Medicare Enrollment	Mr.	Johnson	Kent	E	1-518-727-5630					kent.johnson@optum.com	64 Loughberry Lake Road		Saratoga Springs	NY	12866	08/24/2020	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Chief Financial Officer	CFO, OptumRx	Ms.	Carey	Kathryn		1-952-205-2554					kathryn.carey@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/24/2022	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	CMS Casework Communication Contact	Medicare EGWP Compliance Officer, OptumRx	Ms.	Shocklee	Beth		1-301-775-6358					beth.shocklee@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	05/25/2022	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Coordination of Benefits Contact	OptumRx EGWP COB Mailbox		EGWP COB Mailbox	OptumRx		1-224-231-1694					ORxEGWPCOB@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	08/15/2022	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Customer Service Operations Contact	Manager, Customer Service	Ms.	Ortiz	Lisa Marie		1-714-825-3805					lisamarie.ortiz@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	01/01/2021	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Government Relations Contact	Regulatory Affairs Consultant	Ms.	Thompson	Kristyl		1-612-632-6450					kristyl_m_thompson@optum.com	PO Box 9472		Minneapolis	MN	55440	09/14/2017	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Hospice Contact	Pharmacist		Cast	Neal		1-405-246-2763					neal.cast@optum.com	PO Box 9472		Minneapolis	MN	55440	01/17/2018	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Medicare Compliance Officer	Medicare EGWP Compliance Officer	Ms.	Shocklee	Beth		1-301-775-6358					beth.shocklee@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	08/14/2020	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Part D Exceptions Contact	Manager, Prior Authorization	Mr.	Bricker	Bryce							bryce.m.bricker@optum.com	9040 S. Rita Rd.		Tucson	AZ	85746	01/04/2021	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	1-612-632-6838				Medicare Prescription Drug Plan		5	San Francisco
S8841	Pharmacy Network Management Contact	Director Network Contracting	Mr.	Hagan	Kyle		1-303-989-5288					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	01/04/2021	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S8841	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd							todd.summers@optum.com	755 Research Pkwy	Suite 300	Oklahoma City	OK	73104	08/16/2018	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	1-866-443-1095				Medicare Prescription Drug Plan		5	San Francisco
S8841	Plan to Plan Reconciliation Contact	Manager, Business Process	Mr.	Diaz	Mario		1-949-475-3517					mario.diaz@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/26/2017	2023	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	San Francisco
S9409	Automated TrOOP Balance Transfer Contact	Sr. Project Manager		Rush	Jamie		1-314-354-1103					ESITroopTransfer@express-scripts.com	One Express Way		St.Louis	MO	63121	05/31/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Best Available Evidence Contact	Manager, Enrollment and Billing		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road Suite 200		Glen Allen	VA	23060	06/17/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Chief Financial Officer	SVP, Controller	Mr.	Pisarik	Jason		1-248-665-4348					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	VT	05601	02/09/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	CMS Casework Communication Contact	Compliance Consultant		White	Jasmin		1-248-665-4235					JWhite4@bcbsm.com	1000 Town Center		Southfield	MI	48075	02/09/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Coordination of Benefits Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	06/01/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Customer Service Operations Contact	Director, Workforce Management, Analytics, & Supp		Weber	Julie		1-313-225-0555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	02/09/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Government Relations Contact	Manager, Performance and Oversight		Martell	Stacey		1-313-806-5905					smartell@bcbsm.com	1000 Town Center		Southfield	MI	48075	02/09/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Hospice Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		1-954-498-5880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/23/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Part D Exceptions Contact	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	05/31/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-614-336-3326				Medicare Prescription Drug Plan		5	Chicago
S9409	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Healther		1-314-692-1866					hakelly@express-scripts.com	One Express Way		St.Louis	MO	63121	05/31/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9409	Pharmacy Technical Help Desk Contact	Director of Operations, Contact Center		Liu	Ian							iliu@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	05/31/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-922-1557				Medicare Prescription Drug Plan		5	Chicago
S9409	Plan to Plan Reconciliation Contact	SVP, Controller		Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/09/2022	2023	VERMONT BLUE ADVANTAGE, INC.	PDP	Vermont Blue Advantage	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Automated TrOOP Balance Transfer Contact	Operations Manager, Enrollment & Eligibility		Sherman	Mandy		1-920-221-4083				1-920-221-4583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/09/2022	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Best Available Evidence Contact	Product Manager, IT Client Operations		Matteson	Michelle		1-920-221-4104				1-920-221-4604	michelle.matteson@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/15/2018	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Chief Financial Officer	Chief Financial Officer	Mr.	Ruplinger	Randy		1-608-827-4030					hpmscfo.inbox@deancare.com	1277 Deming Way		Madison	WI	53717	08/31/2017	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	CMS Casework Communication Contact	Associate Director, Utilization Management		Semrow	Laura		1-920-221-4129				1-920-221-4629	laura.semrow@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/09/2020	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Coordination of Benefits Contact	Associate Director, Technical Operations		Brenner	Brian		1-920-221-4053				1-920-221-4553	Brian.Brenner@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/21/2017	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Customer Service Operations Contact	Manager, Customer Care Accounts		Nett	Danielle		1-920-221-4224					Danielle.Nett@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/16/2021	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Government Relations Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		1-920-221-4087				1-920-221-4587	scott.jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/13/2022	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Hospice Contact	Operations Manager, Enrollment and Eligibility		Sherman	Mandy		1-920-212-4083				1-920-221-4583	Mandy.Sherman@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/09/2022	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Specht	Jacob		1-608-827-4209					Jacob.Specht@deancare.com	1277 Deming Way		Madison	WI	53717	03/01/2022	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Part D Exceptions Contact	Sr. Manager, Clinical Prior Authorization		LeClair	Christophe						1-920-221-4676	Christopher.Leclair@navitus.com	1025 W. Navitus Drive		Appleton	WI	54913	11/09/2020	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active	1-920-221-4176				Medicare Prescription Drug Plan		5	Chicago
S9701	Pharmacy Network Management Contact	Director, Pharmacy Performance		Robinson	Jan		1-608-729-1688				1-608-729-2688	Jan.Robinson@navitus.com	361 Integrity Drive		Madison	WI	53717	11/09/2020	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9701	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						1-866-595-1975	Danielle.Nett@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/09/2021	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active	1-866-270-3877				Medicare Prescription Drug Plan		5	Chicago
S9701	Plan to Plan Reconciliation Contact	Financial Analyst, Medicare Part D		Seehafer	Angela		1-920-221-4098				1-920-221-4598	Angela.Seehafer@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/02/2022	2023	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Automated TrOOP Balance Transfer Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Best Available Evidence Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	02/13/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Chief Financial Officer	SVP, Controller	Mr.	Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/13/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	CMS Casework Communication Contact	Compliance Consultant		White	Jasmin		1-248-665-4235					JWhite4@bcbsm.com	1000 Town Center		Southfield	MI	48075	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Coordination of Benefits Contact	Manager		LaMontagne	Amanda		1-508-439-9720					amanda.lamontagne@advantasure.com	4121 Cox Road	Suite 200	Glen Allen	VA	23060	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Customer Service Operations Contact	Director, Workforce Management, Analytics, & Supp		Weber	Julie		1-313-225-0555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	02/13/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Government Relations Contact	Manager, Program Oversight		Martell	Stacey		1-313-806-5905					smartell@bcbsm.com	1000 Town Center		Southfield	MI	48075	02/13/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Hospice Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Medicare Compliance Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		1-313-225-8554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/22/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Part D Exceptions Contact	Director, Medicare Programs		Frank	Jesica							frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-855-344-0930				Medicare Prescription Drug Plan		5	Chicago
S9854	Pharmacy Network Management Contact	Director, Medicare Programs		Frank	Jesica		1-515-376-7878					frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S9854	Pharmacy Technical Help Desk Contact	Director, Medicare Programs		Frank	Jesica							frankj@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	1-800-600-8065				Medicare Prescription Drug Plan		5	Chicago
S9854	Plan to Plan Reconciliation Contact	SVP, Controller	Mr.	Pisarik	Jason		1-517-708-5285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/13/2022	2023	WELLMARK ADVANTAGE HEALTH PLAN, INC.	PDP	Wellmark Advantage Health Plan	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
X0001	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		1-502-476-8814					HumanaEOBTransfer@humana.com	515 W. Market Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	Best Available Evidence Contact	Associate Dir., Consumer Service		Beasley	Tasha		1-502-476-7452					MedicareLINET@humana.com	500 West main Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	Chief Financial Officer	Chief Financial Officer	Ms.	Diamond	Susan		1-502-476-2534					sdiamond@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	CMS Casework Communication Contact			Beasley	Tasha		1-502-476-6134					tcovington1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		1-502-580-4329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	Customer Service Operations Contact			Beasley	Tasha		1-502-476-6134					tcovington1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	Government Relations Contact	MCO		Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		1-502-301-2619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		1-502-580-0428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia
X0001	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active	1-502-580-9138				Point-of-Sale Contractor		5	Philadelphia
X0001	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active	1-800-865-8715				Point-of-Sale Contractor		5	Philadelphia
X0001	Plan to Plan Reconciliation Contact	Director, Financial Planning		Snearly	John		1-502-580-3915				1-502-508-3512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	45263-5600	12/29/2022	2023	LIMITED INCOME NET PROGRAM	POS Contractor	Medicare's Limited Income NET Program	Point-of-Sale Contractor		Humana NET Demo	401	Yes	Active					Point-of-Sale Contractor		5	Philadelphia